| Realign Your Mind Counseling Services | |
|
6372 Mechanicsville Tpke Ste 111 Mechanicsville VA 23111-4705 | |
| (804) 477-4808 | |
| (804) 592-6971 |
| Full Name | Realign Your Mind Counseling Services |
|---|---|
| Speciality | Counselor |
| Location | 6372 Mechanicsville Tpke Ste 111, Mechanicsville, Virginia |
| Authorized Official Name and Position | Nicole Holler-blackmon (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 8044774808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Realign Your Mind Counseling Services 6372 Mechanicsville Tpke Ste 111 Mechanicsville VA 23111-4705 Ph: (804) 477-4808 | Realign Your Mind Counseling Services 6372 Mechanicsville Tpke Ste 111 Mechanicsville VA 23111-4705 Ph: (804) 477-4808 |
| NPI Number | 1427638345 |
|---|---|
| Provider Enumeration Date | 04/13/2021 |
| Last Update Date | 02/05/2024 |
| Certification Date | 02/05/2024 |
| Medicare PECOS PAC ID | 4385091172 |
|---|---|
| Medicare Enrollment ID | O20240216000743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427638345 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Jenine Stallings |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659813806 PECOS PAC ID: 2567819352 Enrollment ID: I20231116001037 |
| Provider Name | Nicole Renae Holler-blackmon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518545649 PECOS PAC ID: 9537503669 Enrollment ID: I20240216002822 |
| Provider Name | Karla Charinne Ramos-cavitt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619667714 PECOS PAC ID: 6709220841 Enrollment ID: I20240216003181 |
| Provider Name | Daniell Twyman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407368483 PECOS PAC ID: 8628414802 Enrollment ID: I20240311000817 |
| Provider Name | Harlee Mariah Marsh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699543520 PECOS PAC ID: 0941646137 Enrollment ID: I20240311001408 |
| Provider Name | Lauren Brittany Clear |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700342292 PECOS PAC ID: 0749626489 Enrollment ID: I20240315002257 |
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