Healthcare Provider Details

I. General information

NPI: 1770438863
Provider Name (Legal Business Name): LENISHA M MILOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 MOOREFIELD PARK DR STE 210
NORTH CHESTERFIELD VA
23236-3675
US

IV. Provider business mailing address

812 MOOREFIELD PARK DR STE 210
NORTH CHESTERFIELD VA
23236-3675
US

V. Phone/Fax

Practice location:
  • Phone: 804-592-6620
  • Fax:
Mailing address:
  • Phone: 804-592-6620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701015928
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: