Healthcare Provider Details

I. General information

NPI: 1568214237
Provider Name (Legal Business Name): NEW INSIGHT CLINICAL COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11357 NUCKOLS RD # 1115
GLEN ALLEN VA
23059-5504
US

IV. Provider business mailing address

11357 NUCKOLS RD # 1115
GLEN ALLEN VA
23059-5504
US

V. Phone/Fax

Practice location:
  • Phone: 804-424-0230
  • Fax: 804-203-1665
Mailing address:
  • Phone: 804-424-0230
  • Fax: 804-203-1665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SHABRIAL HENDERSON
Title or Position: OWNER
Credential: LCSW
Phone: 804-267-0605