Healthcare Provider Details

I. General information

NPI: 1336860394
Provider Name (Legal Business Name): PERSPECTIVE COUNSELING AND THERAPEUTIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

467 LENA LN
FRUITLAND MD
21826-2034
US

IV. Provider business mailing address

3419 VIRGINIA BEACH BLVD # 5383
VIRGINIA BEACH VA
23452-4419
US

V. Phone/Fax

Practice location:
  • Phone: 410-422-6396
  • Fax:
Mailing address:
  • Phone: 410-422-6396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAKIRA C MILLER
Title or Position: OWNER/OUTPATIENT THERAPIST
Credential: M.ED, LPC
Phone: 410-422-6396