| NPI | 1124806997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEVI LIPOVENKO Chairman Of The Board 804-446-1710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2024-12-25 |