| NPI | 1053925727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAQUANA RICHMOND COO 336-283-2699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 175T00000X Peer Specialist | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2021-11-09 |