Organization Name: | INDEPENDENCE PSYCHOTHERAPY SERVICES LLC |
NPI Number: | 1306235783 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDA BOURDON REIN (DIRECTOR) |
Mailing Address: | 215 Mclaws Cir Suite 1 Williamsburg |
State: | VA US |
Postal Code: | 231855799 |
Phone Number: | 7573456428 |
Fax Number: | 7573456808 |
NPI Enumeration Date: | 01/22/2015 |
NPI Last Update Date: | 01/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 07010005880 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |