Resiliency Mental Health Services Llc | |
426 E Freemason St Ste 250 Norfolk VA 23510-2688 | |
(757) 672-4386 | |
Not Available |
Full Name | Resiliency Mental Health Services Llc |
---|---|
Speciality | Social Worker |
Location | 426 E Freemason St Ste 250, Norfolk, Virginia |
Authorized Official Name and Position | Anthony Joseph Harris (OWNER) |
Authorized Official Contact | 7576724386 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Resiliency Mental Health Services Llc 212 Earle Ct Newport News VA 23608-8925 Ph: (757) 672-4386 | Resiliency Mental Health Services Llc 426 E Freemason St Ste 250 Norfolk VA 23510-2688 Ph: (757) 672-4386 |
NPI Number | 1346893500 |
---|---|
Provider Enumeration Date | 07/17/2019 |
Last Update Date | 02/19/2020 |
Certification Date | 02/19/2020 |
Medicare PECOS PAC ID | 8527494350 |
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Medicare Enrollment ID | O20200213003052 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346893500 | NPI | - | NPPES |
601333373 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Anthony Joseph Harris |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1578089033 PECOS PAC ID: 9436585262 Enrollment ID: I20200219002575 |
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