Healthcare Provider Details

I. General information

NPI: 1083860274
Provider Name (Legal Business Name): PLENTIFUL HARVEST MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2008
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 THREE WILLOWS CT
RICHMOND VA
23294-4026
US

IV. Provider business mailing address

PO BOX 2552
RICHMOND VA
23218-2552
US

V. Phone/Fax

Practice location:
  • Phone: 804-337-2939
  • Fax:
Mailing address:
  • Phone: 804-337-2939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. MARY ROBERSON WINTERS
Title or Position: CLINICAL PASTORAL COUNSELOR
Credential: DOCTOR OF PHILOSOPHY
Phone: 804-337-2939