| Painted Bird Psychotherapy Llc | |
|
4303 Cappahosic Rd Gloucester VA 23061-3300 | |
| (757) 524-2124 | |
| Not Available |
| Full Name | Painted Bird Psychotherapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4303 Cappahosic Rd, Gloucester, Virginia |
| Authorized Official Name and Position | Desiree Devonne Smith (OWNERR) |
| Authorized Official Contact | 7572142934 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Painted Bird Psychotherapy Llc 4303 Cappahosic Rd Gloucester VA 23061-3300 Ph: (757) 524-2124 | Painted Bird Psychotherapy Llc 4303 Cappahosic Rd Gloucester VA 23061-3300 Ph: (757) 524-2124 |
| NPI Number | 1982219044 |
|---|---|
| Provider Enumeration Date | 09/14/2020 |
| Last Update Date | 01/28/2023 |
| Certification Date | 01/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982219044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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