Healthcare Provider Details

I. General information

NPI: 1013698737
Provider Name (Legal Business Name): REFOCUS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11923 CENTRE ST STE C
CHESTER VA
23831-1702
US

IV. Provider business mailing address

3200 RANSOM HILLS RD
NORTH CHESTERFIELD VA
23237-3571
US

V. Phone/Fax

Practice location:
  • Phone: 804-306-8909
  • Fax:
Mailing address:
  • Phone: 804-502-3723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TREVENE GORDON
Title or Position: CEO
Credential: LPC, LSATP
Phone: 804-502-3723