| Resilience Counseling & Social Skills Center Llc | |
|
5374 Twin Hickory Rd Glen Allen VA 23059-5682 | |
| (540) 699-0226 | |
| (540) 699-0224 |
| Full Name | Resilience Counseling & Social Skills Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 5374 Twin Hickory Rd, Glen Allen, Virginia |
| Authorized Official Name and Position | Karl George Memmer (OWNER/LPC) |
| Authorized Official Contact | 5406990226 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resilience Counseling & Social Skills Center Llc 306 Westwood Office Park Fredericksburg VA 22401-5108 Ph: (540) 699-0226 | Resilience Counseling & Social Skills Center Llc 5374 Twin Hickory Rd Glen Allen VA 23059-5682 Ph: (540) 699-0226 |
| NPI Number | 1245724707 |
|---|---|
| Provider Enumeration Date | 06/19/2018 |
| Last Update Date | 11/13/2019 |
| Medicare PECOS PAC ID | 4082088570 |
|---|---|
| Medicare Enrollment ID | O20230323003305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245724707 | NPI | - | NPPES |
| Provider Name | Kate T Tibbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497091938 PECOS PAC ID: 3870731201 Enrollment ID: I20130524000391 |
| Provider Name | Joshua K Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861796690 PECOS PAC ID: 8426316555 Enrollment ID: I20171219002926 |
| Provider Name | Cristina Daniels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881227775 PECOS PAC ID: 4981028388 Enrollment ID: I20200717002129 |
| Provider Name | Jeffrey Byrne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033571534 PECOS PAC ID: 3375809478 Enrollment ID: I20230629004153 |
| Provider Name | Erin Looby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902574403 PECOS PAC ID: 0547622342 Enrollment ID: I20230810002128 |
| Provider Name | Eron Cavanaugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871144287 PECOS PAC ID: 3072963883 Enrollment ID: I20231220000508 |
| Provider Name | Alexandra Holder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225475106 PECOS PAC ID: 7719337567 Enrollment ID: I20231220002136 |
| Provider Name | Kristina Bonanca |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104350610 PECOS PAC ID: 6103276837 Enrollment ID: I20231221001204 |
| Provider Name | Kristina Stone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114563509 PECOS PAC ID: 2062862790 Enrollment ID: I20231221001404 |
| Provider Name | Louisa White |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487242996 PECOS PAC ID: 3971953563 Enrollment ID: I20231222000040 |
| Provider Name | William Datta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912548538 PECOS PAC ID: 5092165258 Enrollment ID: I20231229001889 |
| Provider Name | Samantha Moussari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558096529 PECOS PAC ID: 7214388867 Enrollment ID: I20240108004097 |
| Provider Name | Maryann Byrne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851715312 PECOS PAC ID: 3173975653 Enrollment ID: I20240119003363 |
| Provider Name | Pamela Jane Pitchford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831247683 PECOS PAC ID: 0749632230 Enrollment ID: I20240119003677 |
| Provider Name | Robert Raborn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477952760 PECOS PAC ID: 1658717970 Enrollment ID: I20240308003015 |
| Provider Name | Sandra Gedney Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205440518 PECOS PAC ID: 1759727084 Enrollment ID: I20240308003439 |
| Provider Name | Karl George Memmer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992247548 PECOS PAC ID: 6800260399 Enrollment ID: I20240311001084 |
| Provider Name | Katelyn Kiley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104410083 PECOS PAC ID: 0143666347 Enrollment ID: I20240311001717 |
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