Provider Demographics
NPI:1598291247
Name:EXZIS LLC
Entity Type:Organization
Organization Name:EXZIS LLC
Other - Org Name:ZEDRIAN INTERVENTION SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:NARH
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP-S
Authorized Official - Phone:804-522-3777
Mailing Address - Street 1:742 WINDOMERE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-2957
Mailing Address - Country:US
Mailing Address - Phone:804-806-1133
Mailing Address - Fax:
Practice Address - Street 1:742 WINDOMERE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-2957
Practice Address - Country:US
Practice Address - Phone:770-334-1003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty