Nova Health and Wellness LLC

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

Legal business name

NOVA HEALTH AND WELLNESS LLC

Practice address

13305 Old Barn CT
Midlothian, VA 23112-4874

Phone

(804) 601-0042

Fax

(804) 706-1640

NPI assigned

Oct 18, 2019

Organization subpart

No

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

Authorized official

Name

Khidhra S Poole, DSW, LCSW

Title

Ceo

Phone

(804) 601-0042

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571356800000",
    "number": "1972146223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13305 OLD BARN CT",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124874",
            "telephone_number": "804-601-0042",
            "fax_number": "804-706-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13305 OLD BARN CT",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124874",
            "telephone_number": "804-601-0042",
            "fax_number": "804-706-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-18",
        "last_updated": "2019-10-18",
        "status": "A",
        "authorized_official_last_name": "POOLE",
        "authorized_official_first_name": "KHIDHRA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-601-0042",
        "authorized_official_credential": "DSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assistant Behavior Analyst in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Assistant Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; 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.