| NPI | 1497611198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVONNA MARTIN Licensed Professional Counselor 804-247-3611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 103T00000X Psychologist |
| 104100000X Social Worker | |
| 235Z00000X Speech-Language Pathologist, | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2025-12-27 |
| Last Update Date | 2026-07-11 |