Provider Demographics
NPI:1114237476
Name:CHILD ADVOCACY CENTER
Entity Type:Organization
Organization Name:CHILD ADVOCACY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAC MH PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-643-7226
Mailing Address - Street 1:103 E GRACE ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-1741
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 E BROAD ST
Practice Address - Street 2:LL 40
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-1928
Practice Address - Country:US
Practice Address - Phone:804-643-7226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREATER RICHMOND SCAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004755101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty