| Phoenix Counselinggroup And Play Therapycenter, Pllc | |
|
7051 Heathcote Village Way Ste 125 Gainesville VA 20155-3198 | |
| (571) 237-4556 | |
| (833) 702-9006 |
| Full Name | Phoenix Counselinggroup And Play Therapycenter, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 7051 Heathcote Village Way Ste 125, Gainesville, Virginia |
| Authorized Official Name and Position | Douglas Robert Mccracken (CEO) |
| Authorized Official Contact | 5712374556 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Counselinggroup And Play Therapycenter, Pllc 7051 Heathcote Village Way Ste 125 Gainesville VA 20155-3198 Ph: (571) 237-4556 | Phoenix Counselinggroup And Play Therapycenter, Pllc 7051 Heathcote Village Way Ste 125 Gainesville VA 20155-3198 Ph: (571) 237-4556 |
| NPI Number | 1699123380 |
|---|---|
| Provider Enumeration Date | 06/02/2016 |
| Last Update Date | 07/08/2024 |
| Certification Date | 07/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699123380 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0701004422 (Virginia) | Primary |
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