Healthcare Provider Details

I. General information

NPI: 1285321497
Provider Name (Legal Business Name): NLSAW COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 INDEPENDENCE PKWY STE 270
CHESAPEAKE VA
23320-5216
US

IV. Provider business mailing address

1801 SUNSPRITE LOOP
CHESAPEAKE VA
23323-5513
US

V. Phone/Fax

Practice location:
  • Phone: 757-453-4485
  • Fax: 757-463-0573
Mailing address:
  • Phone: 757-453-4485
  • Fax: 757-463-0573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: TAKIYA TAYLOR
Title or Position: LPC CLINICIAN
Credential: LPC, LSATP
Phone: 757-453-4485