Healthcare Provider Details

I. General information

NPI: 1932342359
Provider Name (Legal Business Name): NATIONAL COUNSELING GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2009
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10712 BALLANTRAYE DR STE 304
FREDERICKSBURG VA
22407-4702
US

IV. Provider business mailing address

PO BOX 11247
RICHMOND VA
23230-1247
US

V. Phone/Fax

Practice location:
  • Phone: 540-446-0007
  • Fax: 540-318-5591
Mailing address:
  • Phone: 877-566-9624
  • Fax: 804-533-0512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number352
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARION LONG
Title or Position: VP OF REVENUE CYCLE
Credential:
Phone: 757-678-6234