Healthcare Provider Details

I. General information

NPI: 1740876713
Provider Name (Legal Business Name): HOLISTIC EXPRESSION AND CONSULTATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2020
Last Update Date: 12/14/2020
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 W WILLIAMSBURG RD
SANDSTON VA
23150-2009
US

IV. Provider business mailing address

8300 SIR LIONEL PL
NORTH CHESTERFIELD VA
23237-4727
US

V. Phone/Fax

Practice location:
  • Phone: 804-322-9796
  • Fax: 804-276-4504
Mailing address:
  • Phone: 860-794-7103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: CHRISHONA HENRY
Title or Position: OWNER
Credential: LPC,RN
Phone: 860-794-7103