Organization
MIRROR MENTAL HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER BRUNDIDGE (CEO)
(773) 351-0740
Entity
Organization
Contact information
Practice address
306 TURNER RD STE A, NORTH CHESTERFIELD, VA 23225-6432
(773) 351-0740
Mailing address
151 W COMMERCE RD APT 211, RICHMOND, VA 23224-2372
(773) 354-1531
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/23/2023
Last updated
06/23/2023
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