Organization
INDEPENDENCE PSYCHOTHERAPY SERVICES LLC
Active
Organization
INDEPENDENCE PSYCHOTHERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA BOURDON REIN ED.D., LCP (DIRECTOR)
(757) 345-6428
Entity
Organization
Contact information
Practice address
215 MCLAWS CIR, SUITE 1, WILLIAMSBURG, VA 23185-5799
(757) 345-6428
(757) 345-6808
Mailing address
215 MCLAWS CIR, SUITE 1, WILLIAMSBURG, VA 23185-5799
(757) 345-6428
(757) 345-6808
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
07010005880
VA
101Y00000X
Counselor
08701003392
VA
103TC0700X
Clinical Psychologist
Primary
0810004468
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417232802
INDEPENDENCE CHILD THERAPY SERVICES LLC
VA
Enumeration date
01/22/2015
Last updated
01/22/2015
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