MEDICARE: THE WELLNESS CENTER OF CENTRAL VIRGINIA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	2323445555	VA

General Provider Information

NPI Number	:	1649592106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE WELLNESS CENTER OF CENTRAL VIRGINIA, INC.

Provider Business Mailing Address
First Line	:	PO BOX 74100
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23236-0002
Country	:	US
Telephone Number	:	804-232-8080
Fax Number	:	804-232-8088

Provider Business Practice Location Address
First Line	:	180 BELT BLVD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23224-1204
Country	:	US
Telephone Number	:	804-232-8080
Fax Number	:	804-232-8088

Authorized Official
Title or Position	:	CEO
Name	:	MR. STEPHEN ALEXANDER PARSON JR.
Credential	:
Telephone Number	:	804-310-2444

Provider Enumeration Date	:	02/24/2010
Last Update Date	:	02/24/2010

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