NPI 1104650985 · live from the CMS NPI Registry
Aevum Behavioral Health Va LLC
Counselor, Mental Health in Richmond, VA. National Provider Identifier 1104650985, active.
NPI record
| NPI | 1104650985 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Mental Health 101YM0800X |
| Practice location | 4403 Forest Hill Ave, Richmond, VA 23225 |
| Practice phone | 848-210-0028 |
| Mailing address | 2324 Forest Cir, Toms River, NJ 08755 |
| Enumerated | August 26, 2024 |
| Last updated | September 21, 2024 |
| Authorized official | Levi Lipovenko, Ceo |
| Other names | Aevum Behavioral Health |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Mental Health primary | 101YM0800X | — |
| Psychologist | 103T00000X | — |
| Social Worker, Clinical | 1041C0700X | — |
| Marriage & Family Therapist | 106H00000X | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.