| Five Axes, Llc | |
|
3909 Birdbrook Dr South Chesterfield VA 23834-1691 | |
| (804) 943-8801 | |
| Not Available |
| Full Name | Five Axes, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3909 Birdbrook Dr, South Chesterfield, Virginia |
| Authorized Official Name and Position | Tracie Mccoy Edmonds (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 8049438801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Five Axes, Llc 3909 Birdbrook Dr South Chesterfield VA 23834-1691 Ph: (804) 943-8801 | Five Axes, Llc 3909 Birdbrook Dr South Chesterfield VA 23834-1691 Ph: (804) 943-8801 |
| NPI Number | 1598595969 |
|---|---|
| Provider Enumeration Date | 08/01/2024 |
| Last Update Date | 08/01/2024 |
| Certification Date | 08/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598595969 | NPI | - | NPPES |
| 1245484260 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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