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3630 George Washington Mem Hwy Ste F1 Yorktown VA 23693-3350 | |
| (757) 204-1866 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 3630 George Washington Mem Hwy Ste F1, Yorktown, Virginia |
| Authorized Official Name and Position | Jill M Nardin (PRESIDENT) |
| Authorized Official Contact | 7576391304 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
406 Yorkville Rd Yorktown VA 23692-3426 Ph: (757) 639-1304 | 3630 George Washington Mem Hwy Ste F1 Yorktown VA 23693-3350 Ph: (757) 204-1866 |
| NPI Number | 1427692151 |
|---|---|
| Provider Enumeration Date | 11/06/2019 |
| Last Update Date | 05/21/2024 |
| Certification Date | 05/21/2024 |
| Medicare PECOS PAC ID | 1355883901 |
|---|---|
| Medicare Enrollment ID | O20240611000988 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427692151 | NPI | - | NPPES |
| Provider Name | Christopher W Doriani |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053323139 PECOS PAC ID: 6507869930 Enrollment ID: I20060824000252 |
| Provider Name | Ryane Ashly Montes-torrey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154904423 PECOS PAC ID: 7911308119 Enrollment ID: I20230518003731 |
| Provider Name | Blair Elder Farrar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023572674 PECOS PAC ID: 4183161904 Enrollment ID: I20240730000401 |
| Provider Name | Ariel D Tal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578196382 PECOS PAC ID: 7517407927 Enrollment ID: I20240912001364 |
| Provider Name | Jill M Nardin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326475468 PECOS PAC ID: 7810438272 Enrollment ID: I20240925002365 |
| Provider Name | Michael Peter Morgan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295987592 PECOS PAC ID: 5890227391 Enrollment ID: I20241021004511 |
| Provider Name | Lauri Roselle Stoltzfus |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477011385 PECOS PAC ID: 1557895554 Enrollment ID: I20241113003738 |
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