| Fireside Counseling Llc | |
|
7300 Hanover Green Dr Ste 300e Mechanicsville VA 23111-1705 | |
| (804) 220-0036 | |
| (804) 597-0114 |
| Full Name | Fireside Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 7300 Hanover Green Dr Ste 300e, Mechanicsville, Virginia |
| Authorized Official Name and Position | Christopher Gregory James (OWNER) |
| Authorized Official Contact | 5209779870 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fireside Counseling Llc 7300 Hanover Green Dr Ste 300e Mechanicsville VA 23111-1705 Ph: (804) 220-0036 | Fireside Counseling Llc 7300 Hanover Green Dr Ste 300e Mechanicsville VA 23111-1705 Ph: (804) 220-0036 |
| NPI Number | 1629580139 |
|---|---|
| Provider Enumeration Date | 10/25/2017 |
| Last Update Date | 06/15/2023 |
| Certification Date | 06/15/2023 |
| Medicare PECOS PAC ID | 8921368325 |
|---|---|
| Medicare Enrollment ID | O20180202001575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629580139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904009037 (Virginia) | Primary |
| Provider Name | Christopher Gregory James |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548782378 PECOS PAC ID: 9830459239 Enrollment ID: I20180202001657 |
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