Healthcare Provider Details

I. General information

NPI: 1578803516
Provider Name (Legal Business Name): NATIONAL COUNSELING GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2013
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 GITTINGS ST STE 100
SUFFOLK VA
23434-6101
US

IV. Provider business mailing address

PO BOX 11247
RICHMOND VA
23230-1247
US

V. Phone/Fax

Practice location:
  • Phone: 757-847-9386
  • Fax: 757-252-3272
Mailing address:
  • Phone: 866-566-9624
  • Fax: 804-359-1387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number352
License Number StateVA

VIII. Authorized Official

Name: TAMMY SUE OAKES
Title or Position: ADMINISTRATION COORDINATOR
Credential:
Phone: 804-980-7219