|
| |
|
5014 Monument Ave Richmond VA 23230-3620 | |
| (804) 497-4676 | |
| (804) 497-4677 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 5014 Monument Ave, Richmond, Virginia |
| Authorized Official Name and Position | Tammy Sue Oakes (ADMINISTRATION COORDINATOR) |
| Authorized Official Contact | 8049807219 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 11247 Richmond VA 23230-1247 Ph: (877) 566-9624 | 5014 Monument Ave Richmond VA 23230-3620 Ph: (804) 497-4676 |
| NPI Number | 1710070545 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 08/10/2022 |
| Certification Date | 08/10/2022 |
| Medicare PECOS PAC ID | 9436255205 |
|---|---|
| Medicare Enrollment ID | O20150302000024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710070545 | NPI | - | NPPES |
| 010167329 | Medicaid | VA | |
| 010293502 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 352 (Virginia) | Primary |
| Provider Name | Mark Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346490695 PECOS PAC ID: 0749502565 Enrollment ID: I20141205002124 |
| Provider Name | Nicole Domonique Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154866499 PECOS PAC ID: 2264792969 Enrollment ID: I20180126001633 |
| Provider Name | Dianna L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720591696 PECOS PAC ID: 8527328954 Enrollment ID: I20180205000708 |
| Provider Name | Paul Scardino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629353354 PECOS PAC ID: 7113287244 Enrollment ID: I20180208002901 |
| Provider Name | Tierra Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215458542 PECOS PAC ID: 7719247634 Enrollment ID: I20180213002955 |
| Provider Name | Leah N Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699183012 PECOS PAC ID: 5395072425 Enrollment ID: I20190812002157 |
| Provider Name | Nicole G Gibbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821464405 PECOS PAC ID: 3870925506 Enrollment ID: I20191118001315 |
| Provider Name | Arisza N Hillman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518300516 PECOS PAC ID: 7911336656 Enrollment ID: I20200401002162 |
| Provider Name | Eva L. Voth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083083422 PECOS PAC ID: 8628499381 Enrollment ID: I20200604001148 |
| Provider Name | Cristina Daniels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881227775 PECOS PAC ID: 4981028388 Enrollment ID: I20200717002129 |
| Provider Name | Kristi Rakes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538446968 PECOS PAC ID: 2062673098 Enrollment ID: I20210525001842 |
Broad Rock Counseling And Training Associates Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2545 Bellwood Road, Suite 112, Richmond, VA 23237 Phone: 804-275-9980 Fax: 804-275-9981 | |
Rowe Counseling Services, Llc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 116 Brandon Rd Suite 117, Richmond, VA 23224 Phone: 804-677-1733 Fax: 804-230-1723 | |
Watchtower Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Semmes Ave Apt 613, Richmond, VA 23224 Phone: 804-929-8229 | |
You Matter Residential Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 S 5th St, Richmond, VA 23219 Phone: 804-447-6590 Fax: 804-447-3516 | |
New Living Serivices Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1806 Summit Ave Ste 300, Richmond, VA 23230 Phone: 804-358-9679 |