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Organization
NOVA TELEMENTAL HEALTH LLC
Active
Organization
NOVA TELEMENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY LYNN CIPERA LCSW (OWNER)
(571) 469-7106
Entity
Organization
Contact information
Practice address
10432 BALLS FORD RD STE 300, MANASSAS, VA 20109-2517
(571) 469-7106
Mailing address
10432 BALLS FORD RD STE 300, MANASSAS, VA 20109-2517
(571) 469-7106
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/18/2020
Last updated
11/10/2022
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