| Dan A Kniffen Lcsw Llc | |
|
4100 East Parham Road Suite B Henrico VA 23228 | |
| (804) 755-7323 | |
| (804) 755-1215 |
| Full Name | Dan A Kniffen Lcsw Llc |
|---|---|
| Speciality | Counselor |
| Location | 4100 East Parham Road, Henrico, Virginia |
| Authorized Official Name and Position | Dan A Kniffen (PRESIDENT) |
| Authorized Official Contact | 8047557323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dan A Kniffen Lcsw Llc 4100 East Parham Road Suite B Henrico VA 23228 Ph: (804) 755-7323 | Dan A Kniffen Lcsw Llc 4100 East Parham Road Suite B Henrico VA 23228 Ph: (804) 755-7323 |
| NPI Number | 1417406224 |
|---|---|
| Provider Enumeration Date | 09/22/2016 |
| Last Update Date | 09/22/2016 |
| Medicare PECOS PAC ID | 4880963537 |
|---|---|
| Medicare Enrollment ID | O20170808002337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417406224 | NPI | - | NPPES |
| 8909920 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0904000931 (Virginia) | Primary |
| Provider Name | Dan A Kniffen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336179266 PECOS PAC ID: 8729247382 Enrollment ID: I20120319000010 |
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