| Faithful Foundations Therapy Llc | |
|
203 Glade St Se Wise VA 24293-5711 | |
| (276) 708-7386 | |
| (877) 497-4833 |
| Full Name | Faithful Foundations Therapy Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 203 Glade St Se, Wise, Virginia |
| Authorized Official Name and Position | Rebecca Trout (CLINICAL SUPERVISOR) |
| Authorized Official Contact | 7244202794 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Faithful Foundations Therapy Llc 203 Glade St Se Wise VA 24293-5711 Ph: (276) 708-7386 | Faithful Foundations Therapy Llc 203 Glade St Se Wise VA 24293-5711 Ph: (276) 708-7386 |
| NPI Number | 1316838295 |
|---|---|
| Provider Enumeration Date | 07/10/2025 |
| Last Update Date | 06/12/2026 |
| Certification Date | 06/12/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316838295 | NPI | - | NPPES |
| 3001841158 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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