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Organization
SELF LOVE OUTPATIENT SERVICES
Active
Organization
SELF LOVE OUTPATIENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREOGORY D MARCELLE JR. M.ED., LPC, CAADC (CEO)
(631) 805-3257
Entity
Organization
Contact information
Practice address
306 TURNER RD STE A-B, NORTH CHESTERFIELD, VA 23225-6432
(631) 805-3257
Mailing address
5927 BELSTON CT, NORTH CHESTERFIELD, VA 23234-3214
(631) 805-3257
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/26/2023
Last updated
10/26/2023
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