Healthcare Provider Details

I. General information

NPI: 1801307210
Provider Name (Legal Business Name): PREMIER COUNSELING AND CONSULTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2017
Last Update Date: 10/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 LIMESTONE DR
RICHMOND VA
23224-2829
US

IV. Provider business mailing address

5601 LIMESTONE DR
RICHMOND VA
23224-2829
US

V. Phone/Fax

Practice location:
  • Phone: 804-247-9864
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: RENEE GARDNER
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 804-247-9864