| Community Intervention Group, Llc | |
|
205a Temple Ave Colonial Heights VA 23834-2827 | |
| (804) 715-7022 | |
| Not Available |
| Full Name | Community Intervention Group, Llc |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 205a Temple Ave, Colonial Heights, Virginia |
| Authorized Official Name and Position | Lakeisha Branch (DIRECTOR) |
| Authorized Official Contact | 8047157022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Intervention Group, Llc 5700 Fox Hunt Trl South Chesterfield VA 23803-2284 Ph: (804) 715-7022 | Community Intervention Group, Llc 205a Temple Ave Colonial Heights VA 23834-2827 Ph: (804) 715-7022 |
| NPI Number | 1740858836 |
|---|---|
| Provider Enumeration Date | 06/15/2021 |
| Last Update Date | 06/15/2021 |
| Certification Date | 06/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740858836 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
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