| Prominent Counseling Services, Llc | |
|
8014 Midlothian Tpke Ste 315 North Chesterfield VA 23235-5291 | |
| (804) 716-8908 | |
| (866) 216-5506 |
| Full Name | Prominent Counseling Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 8014 Midlothian Tpke Ste 315, North Chesterfield, Virginia |
| Authorized Official Name and Position | Angela D Craighead (CEO/QMHP) |
| Authorized Official Contact | 8047168908 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prominent Counseling Services, Llc 8014 Midlothian Tpke Ste 315 North Chesterfield VA 23235-5291 Ph: (804) 716-8908 | Prominent Counseling Services, Llc 8014 Midlothian Tpke Ste 315 North Chesterfield VA 23235-5291 Ph: (804) 716-8908 |
| NPI Number | 1093282790 |
|---|---|
| Provider Enumeration Date | 10/31/2018 |
| Last Update Date | 10/31/2018 |
| Medicare PECOS PAC ID | 4688116213 |
|---|---|
| Medicare Enrollment ID | O20240611000307 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093282790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kimberly Sparrow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962180836 PECOS PAC ID: 8921540550 Enrollment ID: I20240611000384 |
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