Organization
YES KIDS COUNT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICKY E TILLMAN (CEO)
(804) 335-5997
Entity
Organization
Contact information
Practice address
3900 CHAMBERLAYNE AVE, SUITE 4, RICHMOND, VA 23227-4202
(804) 264-2964
(804) 264-2965
Mailing address
3900 CHAMBERLAYNE AVE, SUITE 4, RICHMOND, VA 23227-4202
(804) 264-2964
(804) 264-2965
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1202
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1202
—
VA
Enumeration date
08/16/2011
Last updated
08/16/2011
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