Organization
COMMONWEALTH CATHOLIC CHARITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN WHITESIDE LCSW (SUPERVISOR)
(804) 545-5951
Entity
Organization
Contact information
Practice address
1512 WILLOW LAWN DR, RICHMOND, VA 23230-3117
(804) 285-5900
(804) 285-9130
Mailing address
1512 WILLOW LAWN DR, RICHMOND, VA 23230-3117
(804) 285-5900
(804) 285-9130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904005775
VA
Other
Enumeration date
07/05/2006
Last updated
08/22/2020
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