Healthcare Provider Details

I. General information

NPI: 1700780657
Provider Name (Legal Business Name): PREMIER CENTER FOR COUNSELING & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

478 DENBIGH BLVD
NEWPORT NEWS VA
23608-3900
US

IV. Provider business mailing address

478 DENBIGH BLVD
NEWPORT NEWS VA
23608-3900
US

V. Phone/Fax

Practice location:
  • Phone: 757-281-9316
  • Fax: 757-926-0641
Mailing address:
  • Phone: 757-281-9316
  • Fax: 757-926-0641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: WAQIA T RICHARDSON
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 757-281-9316