Healthcare Provider Details

I. General information

NPI: 1033706304
Provider Name (Legal Business Name): THERAPEUTIC COUNSELING & CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2020
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8814 FARGO RD STE 125
RICHMOND VA
23229-4628
US

IV. Provider business mailing address

8814 FARGO RD STE 125
HENRICO VA
23229-4628
US

V. Phone/Fax

Practice location:
  • Phone: 804-322-9955
  • Fax:
Mailing address:
  • Phone: 804-322-9955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TALISHA K GORHAM
Title or Position: OWNER
Credential: LPC
Phone: 804-322-9955