Stacy H. Gill, Llc | |
2405 W Main St Richmond VA 23220-4448 | |
(804) 516-5137 | |
Not Available |
Full Name | Stacy H. Gill, Llc |
---|---|
Speciality | Community/Behavioral Health |
Location | 2405 W Main St, Richmond, Virginia |
Authorized Official Name and Position | Stacy Hamilton Gill (OWNER) |
Authorized Official Contact | 8045165137 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Stacy H. Gill, Llc 2728 Parview Way Glen Allen VA 23059-7470 Ph: (804) 516-5137 | Stacy H. Gill, Llc 2405 W Main St Richmond VA 23220-4448 Ph: (804) 516-5137 |
NPI Number | 1164181962 |
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Provider Enumeration Date | 12/09/2021 |
Last Update Date | 12/17/2021 |
Certification Date | 12/17/2021 |
Medicare PECOS PAC ID | 6002208022 |
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Medicare Enrollment ID | O20220124002171 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164181962 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Stacy H Gill |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1871635904 PECOS PAC ID: 6103923313 Enrollment ID: I20070523000474 |
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