That Counseling Place, Llc | |
930 Cambria St Ne Ste 100 Christiansburg VA 24073-1631 | |
(540) 944-4994 | |
(540) 944-6446 |
Full Name | That Counseling Place, Llc |
---|---|
Speciality | Social Worker |
Location | 930 Cambria St Ne Ste 100, Christiansburg, Virginia |
Authorized Official Name and Position | Selina Harrison Kelly (THERAPIST) |
Authorized Official Contact | 5409444994 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
That Counseling Place, Llc Po Box 6605 Christiansburg VA 24068-6605 Ph: (540) 944-4994 | That Counseling Place, Llc 930 Cambria St Ne Ste 100 Christiansburg VA 24073-1631 Ph: (540) 944-4994 |
NPI Number | 1083287676 |
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Provider Enumeration Date | 07/21/2021 |
Last Update Date | 07/21/2021 |
Certification Date | 07/21/2021 |
Medicare PECOS PAC ID | 9739583337 |
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Medicare Enrollment ID | O20210804000904 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083287676 | NPI | - | NPPES |
1023505047 | Medicaid | VA | |
1023505047 | Other | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Selina Harrison Kelly |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1023505047 PECOS PAC ID: 5294084570 Enrollment ID: I20180820002194 |
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