Organization
PADME WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUISIANA I CANO LPC, LSATP (OWNER/CLINICIAN)
(804) 506-3849
Entity
Organization
Contact information
Practice address
17 E MAIN ST, RICHMOND, VA 23219-2109
(804) 506-3849
(804) 508-6312
Mailing address
704 N 1ST ST, RICHMOND, VA 23219-1310
(804) 506-3849
(804) 508-6312
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336293000
—
VA
Enumeration date
05/08/2020
Last updated
08/27/2021
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