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Organization subpart
No

Provider details

NPI number
Authorized official
LA-TOYA JENKINS (EMPLOYEE)
(804) 404-8241
Entity
Organization

Contact information

Practice address
407 HALIFAX ST STE 3, EMPORIA, VA 23847-1722
(507) 400-8839
(804) 800-4483
Mailing address
PO BOX 5573, RICHMOND, VA 23220-0573

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
07/22/2020
Last updated
09/21/2022
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