| Supportive Care Of Virginia Llc | |
|
831 E Ellerslie Ave Colonial Heights VA 23834-1720 | |
| (718) 298-7345 | |
| Not Available |
| Full Name | Supportive Care Of Virginia Llc |
|---|---|
| Speciality | Psychologist |
| Location | 831 E Ellerslie Ave, Colonial Heights, Virginia |
| Authorized Official Name and Position | Raphael Lichtschein (PRESIDENT) |
| Authorized Official Contact | 7182984375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Supportive Care Of Virginia Llc 27 Randolph Rd Howell NJ 07731-8611 Ph: (718) 298-4375 | Supportive Care Of Virginia Llc 831 E Ellerslie Ave Colonial Heights VA 23834-1720 Ph: (718) 298-7345 |
| NPI Number | 1801485354 |
|---|---|
| Provider Enumeration Date | 01/11/2021 |
| Last Update Date | 01/11/2021 |
| Certification Date | 01/11/2021 |
| Medicare PECOS PAC ID | 2961816731 |
|---|---|
| Medicare Enrollment ID | O20210208000520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801485354 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Katherine Albach |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588647218 PECOS PAC ID: 5597793505 Enrollment ID: I20050801000599 |
| Provider Name | Tina M Fountain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417944992 PECOS PAC ID: 2668407495 Enrollment ID: I20050930000076 |
| Provider Name | Charla W White |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063489862 PECOS PAC ID: 6002873494 Enrollment ID: I20051130000425 |
| Provider Name | Edmund W Creekmore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861441511 PECOS PAC ID: 9830285832 Enrollment ID: I20071023000165 |
| Provider Name | Mary A Dillman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306090287 PECOS PAC ID: 0345405288 Enrollment ID: I20120627000682 |
| Provider Name | Joanna Woodward Mcabee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790058923 PECOS PAC ID: 7113178831 Enrollment ID: I20121106000299 |
| Provider Name | Amanda N Trent |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427308543 PECOS PAC ID: 1355593898 Enrollment ID: I20121210000354 |
| Provider Name | Pamela Kay Meade |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376860213 PECOS PAC ID: 4789871385 Enrollment ID: I20130820000554 |
| Provider Name | Aryn L Rosner Gentry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457767014 PECOS PAC ID: 3375764053 Enrollment ID: I20141021003220 |
| Provider Name | Erin M Shaffer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477084325 PECOS PAC ID: 2163794835 Enrollment ID: I20170816001564 |
| Provider Name | Margaret Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962922484 PECOS PAC ID: 7719252717 Enrollment ID: I20170929003595 |
| Provider Name | Sharon Theiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235799214 PECOS PAC ID: 2860722006 Enrollment ID: I20191001001901 |
| Provider Name | Kendra Armstrong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679036131 PECOS PAC ID: 5496176620 Enrollment ID: I20200526002239 |
| Provider Name | Lauren Carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871048686 PECOS PAC ID: 3971917352 Enrollment ID: I20210126001518 |
| Provider Name | Sheena Althea Lyle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396297875 PECOS PAC ID: 1951701499 Enrollment ID: I20210621001745 |
| Provider Name | Shawn O Utsey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134899958 PECOS PAC ID: 9537558655 Enrollment ID: I20211111000967 |
| Provider Name | Juliet Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841890043 PECOS PAC ID: 4880084003 Enrollment ID: I20211202001513 |
| Provider Name | Jenifer M Fink |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326794785 PECOS PAC ID: 7214322114 Enrollment ID: I20220310002812 |
| Provider Name | Paula Simone Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427718725 PECOS PAC ID: 9032505300 Enrollment ID: I20220413002356 |
| Provider Name | Amanda L Thenor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609223783 PECOS PAC ID: 8224425426 Enrollment ID: I20220418000996 |
| Provider Name | Elspeth Gunnoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497185011 PECOS PAC ID: 1355647132 Enrollment ID: I20220418002503 |
| Provider Name | Julie Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326206012 PECOS PAC ID: 9739566365 Enrollment ID: I20220519001591 |
| Provider Name | Jenelle Anthony |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841447596 PECOS PAC ID: 1557591336 Enrollment ID: I20220602001052 |
| Provider Name | Krystal Marie Woods |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124770953 PECOS PAC ID: 8325426257 Enrollment ID: I20220606002677 |
| Provider Name | Amy R Luckenbill-wheeler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053654889 PECOS PAC ID: 0547648057 Enrollment ID: I20220610001832 |
| Provider Name | Angel Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245983154 PECOS PAC ID: 6507248630 Enrollment ID: I20220805000108 |
| Provider Name | Bright N Olewe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659092500 PECOS PAC ID: 7911375290 Enrollment ID: I20221117000341 |
| Provider Name | Tameika L Elam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508514266 PECOS PAC ID: 6204204019 Enrollment ID: I20221129002986 |
| Provider Name | Christel Earles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043887128 PECOS PAC ID: 7214308410 Enrollment ID: I20230126001505 |
| Provider Name | Ibrahim Iftoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730772369 PECOS PAC ID: 7810306206 Enrollment ID: I20230216000524 |
| Provider Name | Cecilia N Faison Ngwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619694361 PECOS PAC ID: 6204205685 Enrollment ID: I20230315002613 |
| Provider Name | Ahmed Mohamed Gaber Abdulhamed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437707304 PECOS PAC ID: 5597139022 Enrollment ID: I20230323000390 |
| Provider Name | Anita Herrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467150326 PECOS PAC ID: 1254796212 Enrollment ID: I20230428001582 |
| Provider Name | Ebony N Calloway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467987974 PECOS PAC ID: 5294002549 Enrollment ID: I20230711004585 |
| Provider Name | Joyce K. Slater |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366599276 PECOS PAC ID: 0446613483 Enrollment ID: I20230824000623 |
| Provider Name | Alisha K Holben |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003516006 PECOS PAC ID: 8729447933 Enrollment ID: I20230920000080 |
| Provider Name | Sindhu Kodoth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235919523 PECOS PAC ID: 9537516570 Enrollment ID: I20231113001168 |
| Provider Name | Stephanie S Boyles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255099156 PECOS PAC ID: 3870956741 Enrollment ID: I20231213002769 |
| Provider Name | Manju T Jose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023885373 PECOS PAC ID: 5698125029 Enrollment ID: I20240109000113 |
| Provider Name | James S Weima |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891562682 PECOS PAC ID: 6800247123 Enrollment ID: I20240116001917 |
| Provider Name | Denise E Tatum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821670100 PECOS PAC ID: 3971956111 Enrollment ID: I20240124002619 |
| Provider Name | Aziichap B Tung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588295018 PECOS PAC ID: 0446696496 Enrollment ID: I20240314004149 |
| Provider Name | Theresa Nicole Thomas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528770708 PECOS PAC ID: 3072950757 Enrollment ID: I20240318003247 |
| Provider Name | Teswar Wood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851904106 PECOS PAC ID: 9234576265 Enrollment ID: I20240328001136 |
| Provider Name | Jennifer Hess Blake |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801574074 PECOS PAC ID: 6901245935 Enrollment ID: I20240423002904 |
| Provider Name | Monica Lenette Whitlock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124504238 PECOS PAC ID: 5092153163 Enrollment ID: I20240513003000 |
| Provider Name | Amanda Renee Jewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053786202 PECOS PAC ID: 5092157248 Enrollment ID: I20240520003926 |
Royal Family Community Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2457 Boulevard, Colonial Heights, VA 23834 Phone: 804-805-8694 Fax: 804-805-8694 | |
Tricities Community Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2457 Boulevard, Colonial Heights, VA 23834 Phone: 804-247-3997 | |
Swift Creek Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2801 Boulevard, Suite F, Colonial Heights, VA 23834 Phone: 804-334-9862 | |
Renewal Christian Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3606 Boulevard Ste B, Colonial Heights, VA 23834 Phone: 804-505-4869 | |
Community Transitional Solutions, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 16029 Continental Blvd, Colonial Heights, VA 23834 Phone: 919-641-8010 | |
Ald Groups Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 Lakeside Dr, Colonial Heights, VA 23834 Phone: 323-497-7039 | |
Healthyminds, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2801 Boulevard, Suite F, Colonial Heights, VA 23834 Phone: 804-479-3515 Fax: 804-898-3999 |