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General NPI Number Information
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NPI Number | 1891892469
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Entity Type | Organization
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Legal Business Name | CENTER FOR COUNSELING AND BEHAVIORAL MEDICINE
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Dates
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Enumeration Date | 09/17/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10106 KRAUSE RD
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City | CHESTERFIELD
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State | VA
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Zip | 23832-6572
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Country | US
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Telephone | 804-717-5419
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Fax | 804-520-8595
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Provider Business Mailing Address
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Address Line | PO BOX 2215
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City | CHESTERFIELD
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State | VA
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Zip | 23832-9112
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Country | US
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Telephone | 804-717-5419
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Fax | 804-520-8595
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. AARON B MEKHOUBAT
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Credential | PH.D.
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Telephone | 804-717-5419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | VA
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