Provider Demographics
NPI:1134827793
Name:NATURE & MOVEMENT, LLC
Entity type:Organization
Organization Name:NATURE & MOVEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:DE LOS REYES
Authorized Official - Last Name:CORONADO MERCER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:804-310-4618
Mailing Address - Street 1:3700 GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1234
Mailing Address - Country:US
Mailing Address - Phone:804-310-4618
Mailing Address - Fax:
Practice Address - Street 1:1401 GREENVILLE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-6912
Practice Address - Country:US
Practice Address - Phone:804-310-4618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA601284053Medicaid