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General NPI Number Information
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NPI Number | 1093250540
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Entity Type | Organization
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Legal Business Name | CIRCLE OF WELLNESS LLC
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Dates
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Enumeration Date | 12/19/2016
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 9321 MIDLOTHIAN TPKE STE C
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4941
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Country | US
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Telephone | 804-252-4525
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Fax | 804-597-0213
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Provider Business Mailing Address
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Address Line | 9321 MIDLOTHIAN TPKE STE C
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4941
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Country | US
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Telephone | 804-252-4525
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MR. LONNELL F LEWIS
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Credential | LCSW
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Telephone | 434-806-3869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0904009706
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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