| Dr. Edythe Bouldin, Lpc | |
|
2025 E Main St Ste 204 Richmond VA 23223-7073 | |
| (804) 647-5564 | |
| Not Available |
| Full Name | Dr. Edythe Bouldin, Lpc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2025 E Main St Ste 204, Richmond, Virginia |
| Authorized Official Name and Position | Edythe Marie Bouldin (CEO) |
| Authorized Official Contact | 8046475564 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Edythe Bouldin, Lpc 2025 E Main St Ste 204 Richmond VA 23223-7073 Ph: (804) 647-5564 | Dr. Edythe Bouldin, Lpc 2025 E Main St Ste 204 Richmond VA 23223-7073 Ph: (804) 647-5564 |
| NPI Number | 1730777087 |
|---|---|
| Provider Enumeration Date | 01/04/2021 |
| Last Update Date | 01/04/2021 |
| Certification Date | 01/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730777087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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