Healthcare Provider Details

I. General information

NPI: 1821358656
Provider Name (Legal Business Name): MSN COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2012
Last Update Date: 07/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 PUMP RD SUITE 220
RICHMOND VA
23233
US

IV. Provider business mailing address

2200 PUMP RD SUITE 220
RICHMOND VA
23233
US

V. Phone/Fax

Practice location:
  • Phone: 703-662-1676
  • Fax: 804-918-1798
Mailing address:
  • Phone: 703-662-1676
  • Fax: 804-918-1798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904005339
License Number StateVA

VIII. Authorized Official

Name: MRS. MARJORIE S NORTH
Title or Position: THERAPIST
Credential: LCSW
Phone: 703-662-1676