Healthcare Provider Details

I. General information

NPI: 1992919062
Provider Name (Legal Business Name): DIALOGUE PATORAL COUNSELING CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 MONUMENT AVE
RICHMOND VA
23226-3547
US

IV. Provider business mailing address

7010 MONUMENT AVE
RICHMOND VA
23226-3547
US

V. Phone/Fax

Practice location:
  • Phone: 804-377-1184
  • Fax: 804-377-6118
Mailing address:
  • Phone: 804-377-1184
  • Fax: 804-377-6118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number0701001951
License Number StateVA

VIII. Authorized Official

Name: MS. DORIS ANN ROSSELL
Title or Position: DIRERCTOR
Credential: LPC
Phone: 804-377-1184