Provider Demographics
NPI:1932954229
Name:WIDENING THE WINDOW PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:WIDENING THE WINDOW PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASSIDY
Authorized Official - Middle Name:ROBINSON
Authorized Official - Last Name:VAN DE GRAAF
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-636-4800
Mailing Address - Street 1:7330 STAPLES MILL RD
Mailing Address - Street 2:PMB #244
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228
Mailing Address - Country:US
Mailing Address - Phone:757-636-4800
Mailing Address - Fax:
Practice Address - Street 1:3708 HARDING DRIVE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321
Practice Address - Country:US
Practice Address - Phone:757-636-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty