| Mr Bradley Todd Kinder, LPC, CSAC | |
|
169 Suffolk Ave Ste 1, Richlands, VA 24641-2434 | |
| (276) 963-0111 | |
| (276) 963-0005 |
| Full Name | Mr Bradley Todd Kinder |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 169 Suffolk Ave Ste 1, Richlands, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154658854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0701004720 (Virginia) | Primary |
| Entity Name | Healing Waters Counseling Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124329388 PECOS PAC ID: 9931362399 Enrollment ID: O20120522001002 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Bradley Todd Kinder, LPC, CSAC Po Box 426, Cedar Bluff, VA 24609-0426 Ph: (276) 963-0111 | Mr Bradley Todd Kinder, LPC, CSAC 169 Suffolk Ave Ste 1, Richlands, VA 24641-2434 Ph: (276) 963-0111 |
Kenny Fields, Counselor Medicare: Not Enrolled in Medicare Practice Location: 169 Suffolk Ave Ste 1, Richlands, VA 24641 Phone: 276-821-2260 | |
Nathan Vicars, Counselor Medicare: Not Enrolled in Medicare Practice Location: 169 Suffolk Ave Ste 1, Richlands, VA 24641 Phone: 276-821-2260 | |
Abbigail Zedd, Counselor Medicare: Not Enrolled in Medicare Practice Location: 169 Suffolk Ave Ste 1, Richlands, VA 24641 Phone: 276-821-2260 | |
Ralph Lambert Lambert, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 106 Ivy Rock Drive, Richlands, VA 24641 Phone: 276-245-6187 | |
Justin Roy, Counselor Medicare: Not Enrolled in Medicare Practice Location: 169 Suffolk Ave Ste 1, Richlands, VA 24641 Phone: 276-821-2260 | |
Fallon Poole, QMHP-T Counselor Medicare: Not Enrolled in Medicare Practice Location: 169 Suffolk Ave Ste 1, Richlands, VA 24641 Phone: 276-821-2260 |