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General NPI Number Information
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NPI Number | 1285335208
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Entity Type | Organization
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Legal Business Name | RAFT HEALTH VIRGINIA LLC
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Dates
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Enumeration Date | 03/16/2023
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | 400 N COLUMBUS ST STE 201
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2264
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Country | US
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Telephone | 202-441-4228
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Fax |
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Provider Business Mailing Address
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Address Line | 2826 OLIVE ST NW
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City | WASHINGTON
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State | DC
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Zip | 20007-3327
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Country | US
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Telephone | 202-441-4228
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | SIU-LIN TING ROBINSON
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Credential | LMSW
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Telephone | 202-441-4228
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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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