| Innovative Renewal Therapy Center Llc | |
|
73 Market St Onancock VA 23417-4223 | |
| (804) 657-7344 | |
| Not Available |
| Full Name | Innovative Renewal Therapy Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 73 Market St, Onancock, Virginia |
| Authorized Official Name and Position | Edwana Cottman (OWNER) |
| Authorized Official Contact | 8046577344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Renewal Therapy Center Llc 73 Market St Onancock VA 23417-4223 Ph: (804) 657-7344 | Innovative Renewal Therapy Center Llc 73 Market St Onancock VA 23417-4223 Ph: (804) 657-7344 |
| NPI Number | 1689140063 |
|---|---|
| Provider Enumeration Date | 10/23/2018 |
| Last Update Date | 10/23/2018 |
| Medicare PECOS PAC ID | 8921480278 |
|---|---|
| Medicare Enrollment ID | O20220802004001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689140063 | NPI | - | NPPES |
| 0904010387 | Other | VA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Edwana Cottman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164927448 PECOS PAC ID: 2567702723 Enrollment ID: I20220906003187 |
Waypoint Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 17263 Dingleys Mill Rd, Onancock, VA 23417 Phone: 717-658-0868 |