1447345145 NPI number — NATIONAL COUNSELING GROUP, INC

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 1447345145 NPI number — NATIONAL COUNSELING GROUP, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL COUNSELING GROUP, INC
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:
EASTERN VIRGINIA COUNSELING GROUP
Provider Other Organization Name Type Code:
4
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:
1447345145
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 11247
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23230-1247
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-566-9624
Provider Business Mailing Address Fax Number:
804-359-1387

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6345 CENTER DR BLDG 14
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23502-4126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-467-8184
Provider Business Practice Location Address Fax Number:
757-467-2485
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
OAKES
Authorized Official First Name:
TAMMY
Authorized Official Middle Name:
SUE
Authorized Official Title or Position:
ADMINISTRATION COORDINATOR
Authorized Official Telephone Number:
804-980-7219

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  352 , 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: 010134200 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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