| River City Counseling Pllc | |
|
14325 Jeffries Pl Midlothian VA 23114-4359 | |
| (804) 822-9840 | |
| Not Available |
| Full Name | River City Counseling Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 14325 Jeffries Pl, Midlothian, Virginia |
| Authorized Official Name and Position | Christie Blaylock Blaylock (OWNER) |
| Authorized Official Contact | 8048229840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River City Counseling Pllc 14325 Jeffries Pl Midlothian VA 23114-4359 Ph: (804) 822-9840 | River City Counseling Pllc 14325 Jeffries Pl Midlothian VA 23114-4359 Ph: (804) 822-9840 |
| NPI Number | 1750054359 |
|---|---|
| Provider Enumeration Date | 07/29/2021 |
| Last Update Date | 04/30/2024 |
| Certification Date | 04/30/2024 |
| Medicare PECOS PAC ID | 5294172664 |
|---|---|
| Medicare Enrollment ID | O20240320003481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750054359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christina L Blaylock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568655199 PECOS PAC ID: 1153382361 Enrollment ID: I20160706002558 |
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