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General NPI Number Information
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NPI Number | 1639011950
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Entity Type | Individual
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Provider Name | ETHAN SCHILLING PHD, LCP, NCSP
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Gender | Male
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 9568 KINGS CHARTER DR STE 100B
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City | ASHLAND
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State | VA
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Zip | 23005-7955
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Country | US
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Telephone | 804-206-9283
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Fax |
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Provider Business Mailing Address
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Address Line | 230 N 6TH ST UNIT 601
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City | RICHMOND
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State | VA
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Zip | 23219-1881
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810009017
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License Number State | VA
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