Provider Demographics
NPI:1598805301
Name:FAMILY INSTITUTE OF VIRGINIA
Entity Type:Organization
Organization Name:FAMILY INSTITUTE OF VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:HADEED
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW,EDD
Authorized Official - Phone:804-355-6876
Mailing Address - Street 1:2910 MONUMENT AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-1404
Mailing Address - Country:US
Mailing Address - Phone:804-355-6876
Mailing Address - Fax:804-355-2597
Practice Address - Street 1:2910 MONUMENT AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-1404
Practice Address - Country:US
Practice Address - Phone:804-355-6876
Practice Address - Fax:804-355-2597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC03383Medicare ID - Type Unspecified