Healthcare Provider Details

I. General information

NPI: 1487743639
Provider Name (Legal Business Name): WEST END FAMILY COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 01/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3932 SPRINGFIELD RD WEST END FAMILY COUNSELING
GLEN ALLEN VA
23060-4119
US

IV. Provider business mailing address

3932 SPRINGFIELD RD
GLEN ALLEN VA
23060-4119
US

V. Phone/Fax

Practice location:
  • Phone: 804-747-8300
  • Fax: 804-747-6215
Mailing address:
  • Phone: 804-747-8300
  • Fax: 804-747-6215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS L TERRACIANO
Title or Position: PRESIDENT
Credential: PHD
Phone: 804-747-8300