| Peaceable Life Therapeutic Services, Inc. | |
|
2857 Stuarts Draft Hwy Unit 121 Stuarts Draft VA 24477-2692 | |
| (540) 414-4561 | |
| (877) 363-9068 |
| Full Name | Peaceable Life Therapeutic Services, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 2857 Stuarts Draft Hwy Unit 121, Stuarts Draft, Virginia |
| Authorized Official Name and Position | Meneika L Chandler (OWNER) |
| Authorized Official Contact | 5404144561 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peaceable Life Therapeutic Services, Inc. Po Box 962 Stuarts Draft VA 24477-0962 Ph: (540) 414-4561 | Peaceable Life Therapeutic Services, Inc. 2857 Stuarts Draft Hwy Unit 121 Stuarts Draft VA 24477-2692 Ph: (540) 414-4561 |
| NPI Number | 1902468846 |
|---|---|
| Provider Enumeration Date | 07/01/2019 |
| Last Update Date | 07/01/2019 |
| Medicare PECOS PAC ID | 0143639815 |
|---|---|
| Medicare Enrollment ID | O20210510001353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902468846 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Deborah J Brinkley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316565518 PECOS PAC ID: 2668754789 Enrollment ID: I20170126000259 |
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