Healthcare Provider Details

I. General information

NPI: 1609794874
Provider Name (Legal Business Name): DELTA PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

897 HENDRICK ST
CULPEPER VA
22701-2201
US

IV. Provider business mailing address

897 HENDRICK ST
CULPEPER VA
22701-2201
US

V. Phone/Fax

Practice location:
  • Phone: 540-827-7367
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: GEORGIA CLORE
Title or Position: CO-OWNER
Credential:
Phone: 540-827-7367