| Invicta Wellness Center | |
|
1101 Professional Dr Ste 101 Williamsburg VA 23185-3301 | |
| (757) 208-5118 | |
| Not Available |
| Full Name | Invicta Wellness Center |
|---|---|
| Speciality | Social Worker |
| Location | 1101 Professional Dr Ste 101, Williamsburg, Virginia |
| Authorized Official Name and Position | Deborah E Elder (OWNER) |
| Authorized Official Contact | 7572085118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Invicta Wellness Center 1101 Professional Dr Ste 101 Williamsburg VA 23185-3301 Ph: (757) 208-5118 | Invicta Wellness Center 1101 Professional Dr Ste 101 Williamsburg VA 23185-3301 Ph: (757) 208-5118 |
| NPI Number | 1952989188 |
|---|---|
| Provider Enumeration Date | 03/30/2021 |
| Last Update Date | 03/30/2021 |
| Certification Date | 03/06/2021 |
| Medicare PECOS PAC ID | 2365829538 |
|---|---|
| Medicare Enrollment ID | O20220510001928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952989188 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Deborah Elder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164762365 PECOS PAC ID: 5597905026 Enrollment ID: I20130705000416 |
| Provider Name | Lori B Larson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578158713 PECOS PAC ID: 2769869270 Enrollment ID: I20220520002162 |
| Provider Name | Whitney Jackson Mclellon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780439059 PECOS PAC ID: 2163967027 Enrollment ID: I20240716000440 |
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