Healthcare Provider Details

I. General information

NPI: 1821911827
Provider Name (Legal Business Name): MIND & BEYOND COUNSELING AND CONSULTING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 MAYLAND DRIVE 10061
RICHMOND VA
23294
US

IV. Provider business mailing address

13 OTSEGO DR # 10061
NEWPORT NEWS VA
23602-2068
US

V. Phone/Fax

Practice location:
  • Phone: 804-384-0495
  • Fax:
Mailing address:
  • Phone: 804-384-0495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRITTNI PETERSEN
Title or Position: OWNER
Credential: LCSW
Phone: 804-384-0495