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General NPI Number Information
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NPI Number | 1477238772
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Entity Type | Organization
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Legal Business Name | DANDAN CLAN LLC
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 9221 FOREST HILL AVE
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City | RICHMOND
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State | VA
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Zip | 23235-6876
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Country | US
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Telephone | 804-326-5539
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Fax | 804-535-4974
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Provider Business Mailing Address
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Address Line | 9221 FOREST HILL AVE
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City | RICHMOND
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State | VA
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Zip | 23235-6876
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Country | US
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Telephone | 804-326-5539
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Fax | 804-535-4974
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Authorized Official
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Title or Position | CEO
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Name | ZIEGFRED LACDAO DANDAN
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Credential | LPC
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Telephone | 804-922-6166
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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 |
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License Number State |
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Taxonomy #2
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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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