Healthcare Provider Details

I. General information

NPI: 1528990785
Provider Name (Legal Business Name): STEFANIE FROELICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4191 INNSLAKE DR STE 212
GLEN ALLEN VA
23060-3324
US

IV. Provider business mailing address

2004 MILBANK RD
RICHMOND VA
23229-4140
US

V. Phone/Fax

Practice location:
  • Phone: 804-303-9622
  • Fax:
Mailing address:
  • Phone: 804-938-4370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020439
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: