Metamorphosis Health and Wellness Center, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

METAMORPHOSIS HEALTH AND WELLNESS CENTER, LLC

Practice address

10106 Krause Rd Ste 206
Chesterfield, VA 23832-6572

Phone

(804) 991-8799

Fax

(804) 777-7770

NPI assigned

Aug 22, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Monica Latriese Holloway, LPC, NCCNPI 1447808274

Title

Owner

Phone

(757) 389-3761

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Monica Latriese Holloway, LPC, NCC

  • Professional Counselor
  • Chesterfield, VA
  • NPI 1447808274
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1962059006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10106 KRAUSE RD STE 206",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326572",
            "telephone_number": "804-991-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10106 KRAUSE RD STE 206",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326572",
            "telephone_number": "804-991-8799",
            "fax_number": "804-777-7770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11800 Centre St",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "VA",
            "postal_code": "238311781",
            "country_code": "US",
            "telephone_number": "757-389-3761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "METAMORPHOSIS HEALTH AND WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-22",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "LATRIESE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-389-3761",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "247726836",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron B Mekhoubat, PH.D.
• Rosa Lita Mendonca
• Mercy and Passion LLC
• Michael Merlino
• Melece Vida Meservy
• Michael Pfab & Ana Raika PC
• Michael Pfab PC
• Jennifer Jan Mihelic, DO
• Amy Dianne Miller, LPC
• Austin Elizabeth Miller, COTA/L

• Professional Counselor in Chesterfield, VA
• Providers in Chesterfield, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.