Healthcare Provider Details

I. General information

NPI: 1629992615
Provider Name (Legal Business Name): COPE LAND SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11505 ALLECNGIE PKWY
NORTH CHESTERFIELD VA
23235-4301
US

IV. Provider business mailing address

3306 O ST
RICHMOND VA
23223-7642
US

V. Phone/Fax

Practice location:
  • Phone: 804-293-0158
  • Fax:
Mailing address:
  • Phone: 804-293-0158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: THERESA GROSSE
Title or Position: OWNER
Credential: LCSW
Phone: 240-388-7870