| Glacier Health And Development Center, Inc | |
|
2006 Bremo Rd Ste 101 Richmond VA 23226-2438 | |
| (804) 918-1115 | |
| (804) 944-2483 |
| Full Name | Glacier Health And Development Center, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 2006 Bremo Rd Ste 101, Richmond, Virginia |
| Authorized Official Name and Position | Robin Denelson Usher (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5717766351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glacier Health And Development Center, Inc 2006 Bremo Rd Ste 101 Richmond VA 23226-2438 Ph: (804) 918-1115 | Glacier Health And Development Center, Inc 2006 Bremo Rd Ste 101 Richmond VA 23226-2438 Ph: (804) 918-1115 |
| NPI Number | 1801421177 |
|---|---|
| Provider Enumeration Date | 03/07/2020 |
| Last Update Date | 11/15/2023 |
| Certification Date | 11/15/2023 |
| Medicare PECOS PAC ID | 9537503008 |
|---|---|
| Medicare Enrollment ID | O20240223000874 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801421177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Robin Denelson Usher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861883969 PECOS PAC ID: 1355785825 Enrollment ID: I20240223001129 |
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