Provider Demographics
NPI: | 1447341805 |
---|---|
Name: | VIRGINIA CENTER FOR FAMILY RELATIONS, PC |
Entity type: | Organization |
Organization Name: | VIRGINIA CENTER FOR FAMILY RELATIONS, PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LARRY |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | FRENCH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MA, LPC, LMFT |
Authorized Official - Phone: | 434-973-5640 |
Mailing Address - Street 1: | 1450 SACHEM PLACE |
Mailing Address - Street 2: | SUITE101 |
Mailing Address - City: | CHARLOTTESVILLE |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 22901 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 434-973-5640 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1450 SACHEM PLACE |
Practice Address - Street 2: | SUITE101 |
Practice Address - City: | CHARLOTTESVILLE |
Practice Address - State: | VA |
Practice Address - Zip Code: | 22901 |
Practice Address - Country: | US |
Practice Address - Phone: | 434-973-5640 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-09-28 |
Last Update Date: | 2008-05-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | 0710000770 | 101YA0400X |
101YM0800X | ||
VA | 0701001071 | 101YM0800X |
VA | 0701001887 | 101YM0800X |
VA | 0701002541 | 101YM0800X |
VA | 0701003925 | 101YM0800X |
VA | 0904003728 | 1041C0700X |
VA | 0904001603 | 1041C0700X |
VA | 0717000095 | 106H00000X |
VA | 0717000162 | 106H00000X |
VA | 0717000431 | 106H00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
VA | 4345708 | Other | LARRY L. FRENCH/AETNA# |
VA | 068091 | Other | LOIS H. MCKIM/ANTHEM # |
VA | 010173132 | Medicaid | |
VA | 1235238197 | Other | LOIS H MCKIM NPI |
VA | 1548370976 | Other | KRISTIN AUGUSTINE NPI |
VA | 800002732 | Other | KRISTIN AUGUSTINE MEDICARE |
VA | 1022108 | Other | LARRY L. FRENCH/CIGNA # |
VA | 1982712071 | Other | ROBERT TUCKER NPI |
VA | 1396842399 | Other | PETER J SCHMIDT NPI |
VA | 324172 | Other | LARRY FRENCH/MHN TRICARE# |
VA | 210166 | Other | ELIZABETH R ADAMS/SOUTHEA |
VA | 800000316 | Other | LOIS H MCKIM MEDICARE |
VA | 082182 | Other | LARRY FRENCH # ANTHEM |
VA | 112348 | Other | PETER J SCHMIDT / ANTHEM# |
VA | 1538250998 | Other | LARRY L FRENCH NPI |
VA | 324177 | Other | PETER J SCHMIDT/MHN TRICA |
VA | 010205930 | Medicaid | |
VA | 1437263837 | Other | BETH ADAMS NPI |
VA | 82120 | Other | LARRY L. FRENCH/SENTARA # |
VA | 800000316 | Other | LOIS H MCKIM MEDICARE |
VA | C06792 | Medicare PIN |