Healthcare Provider Details

I. General information

NPI: 1366812224
Provider Name (Legal Business Name): FIRST CHOICE COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2015
Last Update Date: 10/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 E MAIN ST STE 104
RICHMOND VA
23223-7072
US

IV. Provider business mailing address

14007 RIVERDOWNS NORTH PL
MIDLOTHIAN VA
23113-3965
US

V. Phone/Fax

Practice location:
  • Phone: 804-397-6109
  • Fax:
Mailing address:
  • Phone: 804-397-6109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number0701005787
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number0701005787
License Number StateVA

VIII. Authorized Official

Name: MRS. BREHONDA LEWIS-CUFF
Title or Position: OWNER/OPERATER
Credential:
Phone: 804-397-6109