Provider Demographics
NPI:1942064357
Name:UR STORI: BUILDING RESILIENCE UR WAY
Entity Type:Organization
Organization Name:UR STORI: BUILDING RESILIENCE UR WAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-433-8915
Mailing Address - Street 1:1601 WILLOW LAWN DR. STE. 304
Mailing Address - Street 2:THE SHOPS AT WILLOW LAWN 1219
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230
Mailing Address - Country:US
Mailing Address - Phone:804-433-8915
Mailing Address - Fax:855-276-1131
Practice Address - Street 1:2632 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-2062
Practice Address - Country:US
Practice Address - Phone:804-433-8915
Practice Address - Fax:855-276-1131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty