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Organization
SAFE AND STABLE FAMILIES WELLNESS CENTER, P.C.
Active
Organization
SAFE AND STABLE FAMILIES WELLNESS CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AGUSTIN J CRUZ LPC (CHIEF EXECUTIVE OFFICER)
(229) 412-8125
Entity
Organization
Contact information
Practice address
7825 MIDLOTHIAN TPKE STE 203, NORTH CHESTERFIELD, VA 23235-5247
(229) 412-8125
Mailing address
7825 MIDLOTHIAN TPKE STE 203, NORTH CHESTERFIELD, VA 23235-5247
(229) 412-8125
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0701006356
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
0701006356
VA
101YM0800X
Mental Health Counselor
0701006356
VA
101YP2500X
Professional Counselor
Primary
0701006356
VA
102L00000X
Psychoanalyst
0701006356
VA
103K00000X
Behavior Analyst
0701006356
VA
106H00000X
Marriage & Family Therapist
0717001358
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601092813
—
VA
Enumeration date
04/03/2017
Last updated
04/03/2017
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