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NPI Code Detail

MEDICARE: COMMONWEALTH COUNSELING ASSOCIATES INC

MEDICARE: COMMONWEALTH COUNSELING ASSOCIATES 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
12084P0800XPsychiatry Physician
2363LP0808XPsychiatric/Mental Health Nurse Practitioner
3101YA0400XAddiction (Substance Use Disorder) Counselor
4101YM0800XMental Health Counselor
5101YP2500XProfessional Counselor
61041C0700XClinical Social Worker
7106H00000XMarriage & Family Therapist
8103TC0700XClinical Psychologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1440241OTHERVAANTHEM BCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3270615000OTHERMAGELLAN

General Provider Information

NPI Number : 1851345805
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMONWEALTH COUNSELING ASSOCIATES INC
Provider Business Mailing Address
First Line : 9202 CENTER OAK CT
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23116-2744
Country : US
Telephone Number : 804-207-6737
Fax Number : 804-730-2829
Provider Business Practice Location Address
First Line : 9202 CENTER OAK CT
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23116-2744
Country : US
Telephone Number : 804-207-6737
Fax Number : 804-730-2829
Authorized Official
Title or Position : CHIEF LEGAL OFFICER
Name : RYAN PARDO
Credential :
Telephone Number : 206-399-1493
Provider Enumeration Date : 05/22/2006
Last Update Date : 02/15/2024

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