1750954038 NPI number — DOVE COUNSELING SERVICE

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 1750954038 NPI number — DOVE COUNSELING SERVICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOVE COUNSELING SERVICE
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:
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:
1750954038
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 549
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLOUCESTER
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23061-0549
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-699-3238
Provider Business Mailing Address Fax Number:
804-699-3731

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6558 MAIN ST
Provider Second Line Business Practice Location Address:
MORGAN BLDG. STE 1
Provider Business Practice Location Address City Name:
GLOUCESTER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23061-2306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-699-3238
Provider Business Practice Location Address Fax Number:
804-699-3731
Provider Enumeration Date:
07/23/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FLETCHER
Authorized Official First Name:
ROBIN
Authorized Official Middle Name:
P
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
804-725-3337

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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