| Kmcounselingllc | |
|
23 Groves Ave Alexandria VA 22305-2508 | |
| (703) 887-9476 | |
| Not Available |
| Full Name | Kmcounselingllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 23 Groves Ave, Alexandria, Virginia |
| Authorized Official Name and Position | Kelly Michaels Miller (OWNER) |
| Authorized Official Contact | 7038879476 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kmcounselingllc 23 Groves Ave Alexandria VA 22305-2508 Ph: (703) 887-9476 | Kmcounselingllc 23 Groves Ave Alexandria VA 22305-2508 Ph: (703) 887-9476 |
| NPI Number | 1427440189 |
|---|---|
| Provider Enumeration Date | 03/04/2015 |
| Last Update Date | 07/01/2015 |
| Medicare PECOS PAC ID | 8820304553 |
|---|---|
| Medicare Enrollment ID | O20150826001084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427440189 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0904003516 (Virginia) | Primary |
| Provider Name | Kelly M Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609266865 PECOS PAC ID: 9234445966 Enrollment ID: I20150826001303 |
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