Healthcare Provider Details

I. General information

NPI: 1962086348
Provider Name (Legal Business Name): WOODARD HEALING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 OLD COLONY LN STE A
WILLIAMSBURG VA
23185-3801
US

IV. Provider business mailing address

1117 OLD COLONY LN STE A
WILLIAMSBURG VA
23185-3801
US

V. Phone/Fax

Practice location:
  • Phone: 757-204-9528
  • Fax:
Mailing address:
  • Phone: 757-204-9528
  • Fax:

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: PHILISHA WOODARD
Title or Position: OWNER
Credential: LCSW
Phone: 804-824-8237