Child And Family Guidance | |
230 S Crater Rd Petersburg VA 23803-4424 | |
(804) 733-2180 | |
(804) 733-8502 |
Full Name | Child And Family Guidance |
---|---|
Speciality | Counselor - Mental Health |
Location | 230 S Crater Rd, Petersburg, Virginia |
Authorized Official Name and Position | Warren Gibson Bull (CHEIF EXECUTIVE OFFICER) |
Authorized Official Contact | 8047332180 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Child And Family Guidance 230 S Crater Rd Petersburg VA 23803-4424 Ph: (804) 733-2180 | Child And Family Guidance 230 S Crater Rd Petersburg VA 23803-4424 Ph: (804) 733-2180 |
NPI Number | 1366513715 |
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Provider Enumeration Date | 11/09/2006 |
Last Update Date | 04/01/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366513715 | NPI | - | NPPES |
010026725 | Medicaid | VA | |
010048621 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 328 (Virginia) | Primary |
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