Healthcare Provider Details

I. General information

NPI: 1114838554
Provider Name (Legal Business Name): LIMINAL HEARTS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MAYLAND DR # 11642
RICHMOND VA
23294-4648
US

IV. Provider business mailing address

5501 MERCHANTS VIEW SQ STE 209
HAYMARKET VA
20169-5439
US

V. Phone/Fax

Practice location:
  • Phone: 571-500-1698
  • 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: JASMIN ANTHONY
Title or Position: MANAGING MEMBER
Credential: PH.D., LPC
Phone: 571-500-1698