=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215884226
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LINK WELLNESS OF VA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2026
-----------------------------------------------------
Last Update Date | 03/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2125 HILLIARD RD
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23228-4600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-650-6230
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 180 SYLVAN AVE STE 401
-----------------------------------------------------
City | ENGLEWOOD CLIFFS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07632-2512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-650-6230
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COO
-----------------------------------------------------
Name | GITTY WEITMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 347-841-8943
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------