| Antoinette Place Llc | |
|
11944 Benton Lake Rd Bristow VA 20136-6159 | |
| (240) 533-7437 | |
| Not Available |
| Full Name | Antoinette Place Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 11944 Benton Lake Rd, Bristow, Virginia |
| Authorized Official Name and Position | Antoinette M Lebbie (CEO) |
| Authorized Official Contact | 2405337437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Antoinette Place Llc 11944 Benton Lake Rd Bristow VA 20136-6159 Ph: (240) 533-7437 | Antoinette Place Llc 11944 Benton Lake Rd Bristow VA 20136-6159 Ph: (240) 533-7437 |
| NPI Number | 1134059769 |
|---|---|
| Provider Enumeration Date | 05/25/2026 |
| Last Update Date | 05/25/2026 |
| Certification Date | 05/24/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134059769 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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