Organization
AGEWELL COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRIE LYNN PENDLETON LCSW (OWNER/LICENSED CLINICAL SOCIAL WORK)
(804) 840-2623
Entity
Organization
Contact information
Practice address
5529 SNEAD RD, RICHMOND, VA 23224-6038
(804) 840-2623
Mailing address
PO BOX 5192, MIDLOTHIAN, VA 23112-0020
(804) 840-2623
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904004927
VA
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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