Healthcare Provider Details

I. General information

NPI: 1902134331
Provider Name (Legal Business Name): ASSOCIATED FAMILY AND GROUP COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2009
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 W FRANKLIN ST
RICHMOND VA
23220-4906
US

IV. Provider business mailing address

406 W FRANKLIN ST
RICHMOND VA
23220-4906
US

V. Phone/Fax

Practice location:
  • Phone: 804-837-2805
  • Fax: 804-282-0040
Mailing address:
  • Phone: 804-837-2805
  • Fax: 804-282-0040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0904006248
License Number StateVA

VIII. Authorized Official

Name: MR. JEFFREY T LLOYD
Title or Position: OWNER
Credential: LCSW
Phone: 804-837-2805