| Organization Name: | BROAD ROCK COUNSELING AND TRAINING ASSOCIATES |
| NPI Number: | 1003074493 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOANN M. THOMAS-WILSON (PSYCHOLOGIST) |
| Mailing Address: | 2545 Bellwood Road Suite 112 Richmond |
| State: | VA US |
| Postal Code: | 232374481 |
| Phone Number: | 8042759980 |
| Fax Number: | 8042759981 |
| NPI Enumeration Date: | 06/02/2008 |
| NPI Last Update Date: | 02/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 0810000972 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |