| Rubicon Counseling Llc | |
|
14700 Village Square Pl Midlothian VA 23112-2253 | |
| (434) 962-9730 | |
| Not Available |
| Full Name | Rubicon Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 14700 Village Square Pl, Midlothian, Virginia |
| Authorized Official Name and Position | Mandy Bass (OWNER) |
| Authorized Official Contact | 4349629730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rubicon Counseling Llc 17000 Old Westridge Dr Moseley VA 23120-2340 Ph: (434) 962-9730 | Rubicon Counseling Llc 14700 Village Square Pl Midlothian VA 23112-2253 Ph: (434) 962-9730 |
| NPI Number | 1912592957 |
|---|---|
| Provider Enumeration Date | 03/02/2021 |
| Last Update Date | 02/22/2023 |
| Certification Date | 02/22/2023 |
| Medicare PECOS PAC ID | 4385084417 |
|---|---|
| Medicare Enrollment ID | O20240506003638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912592957 | NPI | - | NPPES |
| 601463797 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Mandy Sue Bass |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396386025 PECOS PAC ID: 6800209131 Enrollment ID: I20240506003827 |
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