Individual
CARLISSA APRIL FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
PO BOX 34, RICHMOND, VA 23218-0034
(336) 682-0041
Mailing address
PO BOX 34, RICHMOND, VA 23218-0034
(336) 692-0041
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704015091
VA
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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