Phoenix Counselinggroup And Play Therapycenter, Pllc | |
6611 Jefferson St Haymarket VA 20169-4902 | |
(571) 248-0626 | |
Not Available |
Full Name | Phoenix Counselinggroup And Play Therapycenter, Pllc |
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Speciality | Counselor - Mental Health |
Location | 6611 Jefferson St, Haymarket, Virginia |
Authorized Official Name and Position | Douglas Robert Mccracken (CEO) |
Authorized Official Contact | 5712480826 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Phoenix Counselinggroup And Play Therapycenter, Pllc 6611 Jefferson St Haymarket VA 20169-4902 Ph: (571) 248-0626 | Phoenix Counselinggroup And Play Therapycenter, Pllc 6611 Jefferson St Haymarket VA 20169-4902 Ph: (571) 248-0626 |
NPI Number | 1699123380 |
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Provider Enumeration Date | 06/02/2016 |
Last Update Date | 06/02/2016 |
Identifier | Type | State | Issuer |
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1699123380 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 0701004422 (Virginia) | Primary |
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