Healthcare Provider Details

I. General information

NPI: 1396318812
Provider Name (Legal Business Name): WYCHE COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 07/22/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SHADY LANE AVE
EMPORIA VA
23847-1919
US

IV. Provider business mailing address

800 SHADY LANE AVE
EMPORIA VA
23847-1919
US

V. Phone/Fax

Practice location:
  • Phone: 434-336-7837
  • Fax: 434-201-7488
Mailing address:
  • Phone: 434-336-7837
  • Fax: 434-201-7488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHAMEKA WYCHE
Title or Position: THERAPIST
Credential: LPC
Phone: 434-336-7837