Organization
HEALTHY MINDS SUPPORTIVE INTERVENTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIAJAH AISHAH MAY QMHP-A/C (CEO)
(434) 294-5601
Entity
Organization
Contact information
Practice address
115 S SYCAMORE ST, PETERSBURG, VA 23803-4279
(434) 294-5601
(804) 722-4001
Mailing address
115 S SYCAMORE ST, PETERSBURG, VA 23803-4279
(434) 294-5601
(804) 722-4001
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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