Organization
THE MAGNOLIA GROUP CENTER FOR HEALTH AND WELLNESS
Active
Other names
The Magnolia Group
Organization subpart
No
Provider details
NPI number
Authorized official
LAKESHA BROUSSARD (DIRECTOR OF SERVICES)
(804) 901-3458
Entity
Organization
Contact information
Practice address
1233 MALL DR, NORTH CHESTERFIELD, VA 23235-4737
(804) 625-9868
Mailing address
8132 FOREST HILL AVE STE A, NORTH CHESTERFIELD, VA 23235-3265
(804) 901-3458
(866) 781-9646
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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