Organization
FAIRLANE COUNSELING ASSOCIATES
Active
Other names
Thriveworks Chesterfield
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA LEE BLAYLOCK LCSW (OWNER)
(804) 419-4122
Entity
Organization
Contact information
Practice address
9846 LORI RD., STE 201, CHESTERFIELD, VA 23832
(804) 419-4122
(804) 419-4122
Mailing address
9846 LORI RD., STE 201, CHESTERFIELD, VA 23832
(804) 419-4122
(804) 419-4122
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003316
VA
Other
Enumeration date
04/11/2014
Last updated
01/15/2015
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