Healthcare Provider Details

I. General information

NPI: 1558208637
Provider Name (Legal Business Name): OSUN FAMILY HEALING SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 PHAUP ST UNIT A
RICHMOND VA
23223
US

IV. Provider business mailing address

1601 WILLOW LAWN DR. STE 304 (#1052)
RICHMOND VA
23230
US

V. Phone/Fax

Practice location:
  • Phone: 725-230-7364
  • Fax: 725-230-7364
Mailing address:
  • Phone: 725-230-7364
  • Fax: 725-230-7364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CLARISSA CANNON
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: LCSW
Phone: 725-230-7364