Nova Telemental Health Llc | |
10432 Balls Ford Rd Ste 300 Manassas VA 20109-2517 | |
(571) 469-7106 | |
Not Available |
Full Name | Nova Telemental Health Llc |
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Speciality | Social Worker |
Location | 10432 Balls Ford Rd Ste 300, Manassas, Virginia |
Authorized Official Name and Position | Kelly Lynn Cipera (OWNER) |
Authorized Official Contact | 5714697106 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Nova Telemental Health Llc 10432 Balls Ford Rd Ste 300 Manassas VA 20109-2517 Ph: (571) 469-7106 | Nova Telemental Health Llc 10432 Balls Ford Rd Ste 300 Manassas VA 20109-2517 Ph: (571) 469-7106 |
NPI Number | 1174146708 |
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Provider Enumeration Date | 05/18/2020 |
Last Update Date | 11/10/2022 |
Certification Date | 11/10/2022 |
Medicare PECOS PAC ID | 2365858438 |
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Medicare Enrollment ID | O20210316000495 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174146708 | NPI | - | NPPES |
Provider Name | Kelly L Cipera |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1174131841 PECOS PAC ID: 8022422757 Enrollment ID: I20210120002673 |
Provider Name | Helen Christine Coronel |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710909205 PECOS PAC ID: 6103285259 Enrollment ID: I20230707000343 |
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