Healthcare Provider Details

I. General information

NPI: 1144096322
Provider Name (Legal Business Name): RICHMOND CENTER FOR EATING DISORDERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11505 ALLECINGIE PKWY
NORTH CHESTERFIELD VA
23235-4301
US

IV. Provider business mailing address

11505 ALLECINGIE PKWY
NORTH CHESTERFIELD VA
23235-4301
US

V. Phone/Fax

Practice location:
  • Phone: 804-285-2625
  • Fax: 804-800-2146
Mailing address:
  • Phone: 804-285-2625
  • Fax: 804-800-2146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIE ANNE SAMITT
Title or Position: OWNER
Credential: LCSW
Phone: 804-767-0111