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General NPI Number Information
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NPI Number | 1366752057
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC INSIGHTS AND MENTORING EXPERIENCES FAMILY SERVICES, LLC
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 33011 INDIANTOWN RD
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City | LOCUST GROVE
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State | VA
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Zip | 22508-2350
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Country | US
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Telephone | 434-989-3579
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Fax | 888-709-1905
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Provider Business Mailing Address
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Address Line | 33011 INDIANTOWN RD
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City | LOCUST GROVE
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State | VA
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Zip | 22508-2350
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Country | US
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Telephone | 434-989-3579
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Fax | 888-709-1905
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. GLORIA S SETTERLUND
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Credential | LPC CSOTP
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Telephone | 434-989-3579
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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 | 149805001
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License Number State | VA
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