| Soaring For Change Counseling Services, Llc | |
|
3320 Plowfield Ct Richmond VA 23223-1272 | |
| (804) 683-8731 | |
| (804) 225-8688 |
| Full Name | Soaring For Change Counseling Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3320 Plowfield Ct, Richmond, Virginia |
| Authorized Official Name and Position | Rasha Nickera Hicks (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8046838731 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soaring For Change Counseling Services, Llc 3320 Plowfield Ct Richmond VA 23223-1272 Ph: (804) 683-8731 | Soaring For Change Counseling Services, Llc 3320 Plowfield Ct Richmond VA 23223-1272 Ph: (804) 683-8731 |
| NPI Number | 1104283191 |
|---|---|
| Provider Enumeration Date | 01/21/2016 |
| Last Update Date | 01/21/2016 |
| Medicare PECOS PAC ID | 1153765102 |
|---|---|
| Medicare Enrollment ID | O20240216003769 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104283191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0701006414 (Virginia) | Primary |
| Provider Name | Rasha N Hicks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669839015 PECOS PAC ID: 3779927728 Enrollment ID: I20240216003917 |
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