Basic Information
| Provider Information | |||||||||
| NPI: | 1265190649 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RAPPAHANNOCK AREA COMMUNITY SERVICES BOARD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 HOPE RD | ||||||||
| Address2: | |||||||||
| City: | STAFFORD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 225547202 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 15 HOPE RD | ||||||||
| Address2: | |||||||||
| City: | STAFFORD | ||||||||
| State: | VA | ||||||||
| PostalCode: | 225547202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5406592725 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2021 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| AuthorizedOfficialLastName: | MCTEER | ||||||||
| AuthorizedOfficialFirstName: | ERICA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MENTAL HEALTH THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 5406592725 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
| NPICertificationDate: | 12/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.