| Casselton Consultants | |
|
4525 W Hundred Rd Chester VA 23831-1741 | |
| (804) 778-7645 | |
| (804) 778-7686 |
| Full Name | Casselton Consultants |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4525 W Hundred Rd, Chester, Virginia |
| Authorized Official Name and Position | Revardo Pretlow (ADMINISTRATOR/OWNER) |
| Authorized Official Contact | 8047787685 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Casselton Consultants 4525 W Hundred Rd Chester VA 23831-1741 Ph: () - | Casselton Consultants 4525 W Hundred Rd Chester VA 23831-1741 Ph: (804) 778-7645 |
| NPI Number | 1760013163 |
|---|---|
| Provider Enumeration Date | 02/04/2020 |
| Last Update Date | 02/09/2023 |
| Certification Date | 02/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760013163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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