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Organization
SPIRITUALLY INSPIRED TRANSFORMATION SERVICES
Active
Organization
SPIRITUALLY INSPIRED TRANSFORMATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAISA GOODWIN (CREDENTIALING CONSULTANT)
(757) 339-8798
Entity
Organization
Contact information
Practice address
104 WEXFORD CT, YORKTOWN, VA 23693-4597
(757) 300-7099
Mailing address
104 WEXFORD CT, YORKTOWN, VA 23693-4597
(757) 300-7099
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904009647
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750823803
—
VA
Enumeration date
05/01/2018
Last updated
05/01/2018
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