| Revelations Counseling & Consulting, Llc | |
|
1380 Central Park Blvd Ste 205 Fredericksburg VA 22401-4926 | |
| (540) 602-2545 | |
| (540) 602-2542 |
| Full Name | Revelations Counseling & Consulting, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1380 Central Park Blvd Ste 205, Fredericksburg, Virginia |
| Authorized Official Name and Position | Samantha Jo Solley (COO) |
| Authorized Official Contact | 5404463978 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revelations Counseling & Consulting, Llc 1380 Central Park Blvd Ste 205 Fredericksburg VA 22401-4926 Ph: (540) 602-2545 | Revelations Counseling & Consulting, Llc 1380 Central Park Blvd Ste 205 Fredericksburg VA 22401-4926 Ph: (540) 602-2545 |
| NPI Number | 1275813347 |
|---|---|
| Provider Enumeration Date | 08/22/2011 |
| Last Update Date | 03/21/2024 |
| Certification Date | 03/21/2024 |
| Medicare PECOS PAC ID | 3971774209 |
|---|---|
| Medicare Enrollment ID | O20110919000363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275813347 | NPI | - | NPPES |
| 0904007474 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0904007474 (Virginia) | Primary |
| Provider Name | Joanne L Strawder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679878300 PECOS PAC ID: 8325219660 Enrollment ID: I20110919000418 |
| Provider Name | Victoria A Tripp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558003574 PECOS PAC ID: 5991180929 Enrollment ID: I20231121001811 |
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