| Riverbend Integrative Therapy Llc | |
|
561 High St Petersburg VA 23803-3859 | |
| (804) 760-8323 | |
| (508) 433-1871 |
| Full Name | Riverbend Integrative Therapy Llc |
|---|---|
| Speciality | Psychologist |
| Location | 561 High St, Petersburg, Virginia |
| Authorized Official Name and Position | Cynthia Jenkins (OWNER) |
| Authorized Official Contact | 5083269929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverbend Integrative Therapy Llc Po Box 2406 Petersburg VA 23804-2406 Ph: (804) 760-8323 | Riverbend Integrative Therapy Llc 561 High St Petersburg VA 23803-3859 Ph: (804) 760-8323 |
| NPI Number | 1962256024 |
|---|---|
| Provider Enumeration Date | 04/15/2024 |
| Last Update Date | 04/15/2024 |
| Certification Date | 04/15/2024 |
| Medicare PECOS PAC ID | 3375089535 |
|---|---|
| Medicare Enrollment ID | O20240724000329 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962256024 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | David B Dameron |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184645939 PECOS PAC ID: 9739147141 Enrollment ID: I20050729000926 |
| Provider Name | Cynthia L Jenkins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356419295 PECOS PAC ID: 6406901057 Enrollment ID: I20090902000596 |
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