Provider Demographics
NPI:1811237241
Name:WEST END LEARNING FOR LIFE LLC
Entity Type:Organization
Organization Name:WEST END LEARNING FOR LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:PARHAM
Authorized Official - Last Name:KIEFER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:804-592-2615
Mailing Address - Street 1:7605 FOREST AVENUE
Mailing Address - Street 2:STE 414
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4941
Mailing Address - Country:US
Mailing Address - Phone:804-592-2615
Mailing Address - Fax:804-592-5301
Practice Address - Street 1:7605 FOREST AVENUE
Practice Address - Street 2:STE 414
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4941
Practice Address - Country:US
Practice Address - Phone:804-592-2615
Practice Address - Fax:804-592-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004088103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty