Provider Demographics
NPI:1710122460
Name:THE HEALING ARTS CENTER OF RICHMOND, PLLC
Entity Type:Organization
Organization Name:THE HEALING ARTS CENTER OF RICHMOND, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:ODETTE
Authorized Official - Last Name:MEYERSOHN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-833-8776
Mailing Address - Street 1:1503 BROOKLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-4707
Mailing Address - Country:US
Mailing Address - Phone:804-833-8776
Mailing Address - Fax:804-254-2024
Practice Address - Street 1:1503 BROOKLAND PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-4707
Practice Address - Country:US
Practice Address - Phone:804-833-8776
Practice Address - Fax:804-254-2024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040059991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010133041Medicaid