| Cncw Llc | |
|
2 Cardinal Park Dr Se Ste 105a Leesburg VA 20175-4448 | |
| (703) 403-9987 | |
| Not Available |
| Full Name | Cncw Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2 Cardinal Park Dr Se Ste 105a, Leesburg, Virginia |
| Authorized Official Name and Position | Hediyeh Godfrey (CO-FOUNDER) |
| Authorized Official Contact | 7034039987 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cncw Llc 19147 Chartier Dr Leesburg VA 20176-1272 Ph: (703) 403-9987 | Cncw Llc 2 Cardinal Park Dr Se Ste 105a Leesburg VA 20175-4448 Ph: (703) 403-9987 |
| NPI Number | 1639751167 |
|---|---|
| Provider Enumeration Date | 04/23/2021 |
| Last Update Date | 04/23/2021 |
| Certification Date | 04/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639751167 | NPI | - | NPPES |
| 1215517156 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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