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NPI Code Detail

MEDICARE: RESILIENCE COUNSELING AND WELLNESS SERVICES, PLLC

MEDICARE: RESILIENCE COUNSELING AND WELLNESS SERVICES, PLLC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1669123311
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESILIENCE COUNSELING AND WELLNESS SERVICES, PLLC
Provider Business Mailing Address
First Line : 4532 FORDHAM RD
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23236-1122
Country : US
Telephone Number : 804-382-1519
Fax Number :
Provider Business Practice Location Address
First Line : 4532 FORDHAM RD
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23236-1122
Country : US
Telephone Number : 804-382-1519
Fax Number :
Authorized Official
Title or Position : OWNER/MANAGER
Name : SYLVIA AMY FUNN
Credential : LPC
Telephone Number : 804-382-1519
Provider Enumeration Date : 01/14/2022
Last Update Date : 01/14/2022

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Directions to “RESILIENCE COUNSELING AND WELLNESS SERVICES, PLLC ” Practice Location

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