Provider Demographics
NPI:1518621259
Name:TELEMENTAL HEALTH ASSOCIATES LLC
Entity Type:Organization
Organization Name:TELEMENTAL HEALTH ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CACY
Authorized Official - Middle Name:
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-573-2433
Mailing Address - Street 1:2304 SINGINGWOODS LN
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-2625
Mailing Address - Country:US
Mailing Address - Phone:804-364-0444
Mailing Address - Fax:
Practice Address - Street 1:2304 SINGINGWOODS LN
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-2625
Practice Address - Country:US
Practice Address - Phone:804-364-0444
Practice Address - Fax:804-207-5607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty