Nova Clinical Counseling Llc | |
14689 Lee Hwy # 645 Gainesville VA 20155-2110 | |
(703) 682-8215 | |
Not Available |
Full Name | Nova Clinical Counseling Llc |
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Speciality | Counselor |
Location | 14689 Lee Hwy # 645, Gainesville, Virginia |
Authorized Official Name and Position | Michelle Gorden (CLINICAL DIRECTOR) |
Authorized Official Contact | 7036828215 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Nova Clinical Counseling Llc Po Box 645 Gainesville VA 20156-0645 Ph: () - | Nova Clinical Counseling Llc 14689 Lee Hwy # 645 Gainesville VA 20155-2110 Ph: (703) 682-8215 |
NPI Number | 1548956196 |
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Provider Enumeration Date | 04/17/2023 |
Last Update Date | 04/17/2023 |
Certification Date | 04/16/2023 |
Medicare PECOS PAC ID | 0648616326 |
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Medicare Enrollment ID | O20240316000328 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548956196 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Michelle Gorden |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1740934181 PECOS PAC ID: 0840634895 Enrollment ID: I20240216003936 |
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