Healthcare Provider Details

I. General information

NPI: 1295689529
Provider Name (Legal Business Name): HEART-LED COUNSELING, CONSULTING, AND COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2026
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MOBJACK PL STE 101
NEWPORT NEWS VA
23606-1957
US

IV. Provider business mailing address

700 MOBJACK PL STE 101
NEWPORT NEWS VA
23606-1957
US

V. Phone/Fax

Practice location:
  • Phone: 757-528-3544
  • Fax: 757-697-2568
Mailing address:
  • Phone: 757-528-3544
  • Fax: 757-697-2568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHARNETTA ROCHELLE WATERS
Title or Position: CEO
Credential: CYMHS, LPC
Phone: 757-528-3544