| Henrico Area Mental Health & Developmental Services | |
|
10299 Woodman Rd Glen Allen VA 23060-4419 | |
| (804) 727-8500 | |
| Not Available |
| Full Name | Henrico Area Mental Health & Developmental Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 10299 Woodman Rd, Glen Allen, Virginia |
| Authorized Official Name and Position | Laura Totty (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8047278585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Henrico Area Mental Health & Developmental Services 10299 Woodman Rd Glen Allen VA 23060 Ph: (804) 727-8500 | Henrico Area Mental Health & Developmental Services 10299 Woodman Rd Glen Allen VA 23060-4419 Ph: (804) 727-8500 |
| NPI Number | 1023119773 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 04/12/2018 |
| Medicare PECOS PAC ID | 8022004811 |
|---|---|
| Medicare Enrollment ID | O20040426000770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023119773 | NPI | - | NPPES |
| 4978544 | Medicaid | VA | |
| 110330 | Other | VA | ANTHEM GROUP NUMBER |
| 4945131 | Medicaid | VA | |
| 153980000 | Other | VA | MAGELLAN GROUP NUMBER |
| 324461 | Other | VA | VALUE OPTIONS GROUP NUMBE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 099 (Virginia) | Primary |
| Provider Name | Julie M Smyser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619990181 PECOS PAC ID: 3870697097 Enrollment ID: I20070328000439 |
| Provider Name | Janice V Atwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366587396 PECOS PAC ID: 2466557673 Enrollment ID: I20070417000548 |
| Provider Name | Michael W Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821279266 PECOS PAC ID: 0941369292 Enrollment ID: I20081031000545 |
| Provider Name | Caroline V Coster |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548478688 PECOS PAC ID: 1456416528 Enrollment ID: I20090224000753 |
| Provider Name | Robert Rigsby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679614929 PECOS PAC ID: 5193882686 Enrollment ID: I20090327000392 |
| Provider Name | Ann Blair Caldwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750522371 PECOS PAC ID: 6901963495 Enrollment ID: I20090327000403 |
| Provider Name | Annamaria Moldovan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316155328 PECOS PAC ID: 0042377491 Enrollment ID: I20090330000435 |
| Provider Name | Debra A Berschbach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659604445 PECOS PAC ID: 1355488172 Enrollment ID: I20091028000342 |
| Provider Name | Sultan A Lakhani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114975471 PECOS PAC ID: 5395887103 Enrollment ID: I20100116000085 |
| Provider Name | Shannon C Garrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699096057 PECOS PAC ID: 8527252907 Enrollment ID: I20101029000543 |
| Provider Name | Kent G Mcdaniel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871640789 PECOS PAC ID: 0648447698 Enrollment ID: I20120117000200 |
| Provider Name | Karen H Branin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740432970 PECOS PAC ID: 0840459616 Enrollment ID: I20120314000379 |
| Provider Name | Leslie A Stephen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669515771 PECOS PAC ID: 6406002682 Enrollment ID: I20120802000614 |
| Provider Name | Jessica Kristin Malloy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861699332 PECOS PAC ID: 1052567120 Enrollment ID: I20120804000147 |
| Provider Name | Karen Welthy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972610723 PECOS PAC ID: 3577562800 Enrollment ID: I20120820000870 |
| Provider Name | Klara Prachar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588087522 PECOS PAC ID: 7618191602 Enrollment ID: I20140613000182 |
| Provider Name | Wendy Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235537218 PECOS PAC ID: 0446578397 Enrollment ID: I20150406001529 |
| Provider Name | Angela C Bowman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356486542 PECOS PAC ID: 0446567697 Enrollment ID: I20150921000984 |
| Provider Name | Alicia C Gist |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457721383 PECOS PAC ID: 9739499542 Enrollment ID: I20151106001657 |
| Provider Name | Terence D Reaves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295106243 PECOS PAC ID: 0143521641 Enrollment ID: I20151228001544 |
| Provider Name | Craig W Swainey |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1437367414 PECOS PAC ID: 9436213634 Enrollment ID: I20160622002301 |
| Provider Name | Crystal T Silvester |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326335894 PECOS PAC ID: 1456639194 Enrollment ID: I20161031001369 |
| Provider Name | Brianna J Hicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821542903 PECOS PAC ID: 1254613441 Enrollment ID: I20170124000837 |
| Provider Name | Rodney D Diehl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376640490 PECOS PAC ID: 0648540773 Enrollment ID: I20170724001747 |
| Provider Name | Donna M Chambers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609917962 PECOS PAC ID: 7113290321 Enrollment ID: I20170911002242 |
| Provider Name | April H Powell-poarch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801977665 PECOS PAC ID: 0345515961 Enrollment ID: I20171009001068 |
| Provider Name | Natalie C Apseloff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811419724 PECOS PAC ID: 8921364449 Enrollment ID: I20171115002943 |
| Provider Name | Doreen C Walters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639211071 PECOS PAC ID: 9537427240 Enrollment ID: I20171228002109 |
| Provider Name | Susan Quach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619301702 PECOS PAC ID: 3577823350 Enrollment ID: I20180216001471 |
| Provider Name | Tamara K Fleming |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447708318 PECOS PAC ID: 6305107012 Enrollment ID: I20180220002908 |
| Provider Name | Priscilla Witwer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003315722 PECOS PAC ID: 1557625365 Enrollment ID: I20180502002545 |
| Provider Name | Mary A Ward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538617519 PECOS PAC ID: 8729339429 Enrollment ID: I20180919001738 |
| Provider Name | Kimberly Ignace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477032282 PECOS PAC ID: 5597004564 Enrollment ID: I20190308002189 |
| Provider Name | Janet Miller Dawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457858607 PECOS PAC ID: 6800136037 Enrollment ID: I20190325002212 |
| Provider Name | Hillary C Wakefield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609413244 PECOS PAC ID: 9436584620 Enrollment ID: I20200116000705 |
| Provider Name | Brittany L Zuniga-fulton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518610021 PECOS PAC ID: 7810381423 Enrollment ID: I20220224002254 |
| Provider Name | Jessica D Byrd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699287805 PECOS PAC ID: 2668866641 Enrollment ID: I20220309000365 |
| Provider Name | Jennifer R Newhard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912177940 PECOS PAC ID: 3173874864 Enrollment ID: I20220811000082 |
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