Provider Demographics
NPI:1710708854
Name:KIND COURAGE THERAPY LLC
Entity type:Organization
Organization Name:KIND COURAGE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPADE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:240-818-1170
Mailing Address - Street 1:440 MONTICELLO AVE STE 1802 PMB 622678
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-2670
Mailing Address - Country:US
Mailing Address - Phone:240-818-1170
Mailing Address - Fax:
Practice Address - Street 1:150 FRANKLIN ST FL 2
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-4017
Practice Address - Country:US
Practice Address - Phone:240-818-1170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty