| New Lyfe Counseling Services | |
|
1601 Ware Bottom Spring Rd Ste 208 Chester VA 23836-2599 | |
| (804) 621-4228 | |
| (804) 621-4231 |
| Full Name | New Lyfe Counseling Services |
|---|---|
| Speciality | Counselor |
| Location | 1601 Ware Bottom Spring Rd Ste 208, Chester, Virginia |
| Authorized Official Name and Position | Detrina Evette Crawley (LPC) |
| Authorized Official Contact | 8046214228 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Lyfe Counseling Services 1601 Ware Bottom Spring Rd Ste 208 Chester VA 23836-2599 Ph: (804) 621-4228 | New Lyfe Counseling Services 1601 Ware Bottom Spring Rd Ste 208 Chester VA 23836-2599 Ph: (804) 621-4228 |
| NPI Number | 1346822392 |
|---|---|
| Provider Enumeration Date | 04/28/2021 |
| Last Update Date | 04/28/2021 |
| Certification Date | 04/28/2021 |
| Medicare PECOS PAC ID | 9335585744 |
|---|---|
| Medicare Enrollment ID | O20240307003182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346822392 | NPI | - | NPPES |
| 605324315 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Detrina Evette Crawley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528504172 PECOS PAC ID: 1153767561 Enrollment ID: I20240307003551 |
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