1336698489 NPI number — ABUNDANT COUNSELING SOLUTIONS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336698489 NPI number — ABUNDANT COUNSELING SOLUTIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABUNDANT COUNSELING SOLUTIONS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336698489
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4004 GENESEE PL
Provider Second Line Business Mailing Address:
101
Provider Business Mailing Address City Name:
LAKE RIDGE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22192-8303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
571-989-2284
Provider Business Mailing Address Fax Number:
571-526-5981

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4004 GENESEE PL
Provider Second Line Business Practice Location Address:
101
Provider Business Practice Location Address City Name:
LAKE RIDGE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22192-8303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-989-2284
Provider Business Practice Location Address Fax Number:
571-526-5981
Provider Enumeration Date:
09/30/2016

Additional Information

Authorized Official

Authorized Official Last Name:
MAJOR
Authorized Official First Name:
MAKEYSHIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
808-343-4010

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  0904007463 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1902106081 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0307-0182 . This is a "CARE FIRST" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4939494 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4563966 . This is a "CIGNA PPO HMO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: TAX ID . This is a "TRICARE STANDARD AND PRIME" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 600880973 . This is a "MAGELLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: NA . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1902106081 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1902106081 . This is a "OPTUM HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1902106081 . This is a "BEACON HEALTH OPTIONS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1902106081 . This is a "VIRGINIA PREMIER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 163654 . This is a "VALUE OPTION" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 334275 . This is a "KAISER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 519217 . This is a "MHN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com