Healthcare Provider Details

I. General information

NPI: 1043303043
Provider Name (Legal Business Name): SMITHFIELD CHRISTIAN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 MAIN ST
SMITHFIELD VA
23430-1345
US

IV. Provider business mailing address

341 MAIN ST
SMITHFIELD VA
23430-1345
US

V. Phone/Fax

Practice location:
  • Phone: 757-356-1813
  • Fax: 757-356-1813
Mailing address:
  • Phone: 757-356-1813
  • Fax: 757-356-1813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701002534
License Number StateVA

VIII. Authorized Official

Name: SHEILA D ROBINETTE
Title or Position: SOLE PROVIDER UNDER THIS NAME
Credential: LPC
Phone: 757-356-1813