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General NPI Number Information
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NPI Number | 1114658465
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Entity Type | Organization
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Legal Business Name | LEVEL UP COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 636 RAVENWOODS DR
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City | CHESAPEAKE
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State | VA
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Zip | 23322-2754
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Country | US
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Telephone | 757-286-2224
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Fax |
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Provider Business Mailing Address
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Address Line | 636 RAVENWOODS DR
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City | CHESAPEAKE
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State | VA
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Zip | 23322-2754
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Country | US
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Telephone | 757-286-2224
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Fax |
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Authorized Official
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Title or Position | MEMBER/PRACTICE MANAGER
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Name | MRS. IAN BOLLING
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Credential | M.A., J.D.
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Telephone | 757-268-1917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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