Individual
EPIPHANY SHALESE SUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC CSAC
Contact information
Practice address
107 S 5TH ST, RICHMOND, VA 23219-3825
(804) 239-8173
Mailing address
107 S 5TH ST, RICHMOND, VA 23219-3825
(804) 239-8173
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710103268
VA
101YP2500X
Professional Counselor
Primary
0701008018
VA
Other
Enumeration date
01/03/2019
Last updated
01/03/2019
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