| Ivy Counseling And Wellness Llc | |
|
2 Boars Head Ln Ste 140 Charlottesville VA 22903-4605 | |
| (434) 260-2454 | |
| Not Available |
| Full Name | Ivy Counseling And Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2 Boars Head Ln Ste 140, Charlottesville, Virginia |
| Authorized Official Name and Position | Adonice D'atre (PROVIDER) |
| Authorized Official Contact | 4342602454 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivy Counseling And Wellness Llc Po Box 54 Ivy VA 22945-0054 Ph: () - | Ivy Counseling And Wellness Llc 2 Boars Head Ln Ste 140 Charlottesville VA 22903-4605 Ph: (434) 260-2454 |
| NPI Number | 1811597164 |
|---|---|
| Provider Enumeration Date | 10/27/2020 |
| Last Update Date | 12/20/2022 |
| Certification Date | 12/20/2022 |
| Medicare PECOS PAC ID | 7012328875 |
|---|---|
| Medicare Enrollment ID | O20201130001246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811597164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Adonice Datre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841542644 PECOS PAC ID: 5092126854 Enrollment ID: I20201130001452 |
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