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General NPI Number Information
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NPI Number | 1093384224
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Entity Type | Organization
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Legal Business Name | BRIGHT FUTURES OF VIRGINIA, LLC
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Dates
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Enumeration Date | 06/22/2021
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Last Update Date | 06/22/2021
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Provider Practice Location Address
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Address Line | 1701 JACQUELIN ST
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City | RICHMOND
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State | VA
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Zip | 23220-6465
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Country | US
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Telephone | 804-874-6177
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Fax | 804-270-5821
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Provider Business Mailing Address
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Address Line | 1701 JACQUELIN ST
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City | RICHMOND
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State | VA
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Zip | 23220-6465
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Country | US
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Telephone | 804-874-6177
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Fax | 804-270-5821
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Authorized Official
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Title or Position | OWNER/CEO/PROGRAM DIRECTOR
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Name | MELISSA MARIA MILLER
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Credential | QMHP
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Telephone | 804-874-6177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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