Organization
ENVISION ONE OUTPATIENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA JONES (PRESIDENT/CEO)
(804) 862-8300
Entity
Organization
Contact information
Practice address
15 GOODRICH AVE, PETERSBURG, VA 23805-2119
(804) 862-8300
(804) 862-8302
Mailing address
15 GOODRICH AVE, PETERSBURG, VA 23805-2119
(804) 862-8300
(804) 862-8302
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
10/02/2014
Last updated
11/14/2014
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