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General NPI Number Information
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NPI Number | 1114790490
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Entity Type | Organization
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Legal Business Name | RADIANT INNOVATIONS COUNSELING SERVICES
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 732 THIMBLE SHOALS SUITE 302A, #1035
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City | NEWPORT NEWS
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State | VA
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Zip | 23606
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Country | US
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Telephone | 757-633-4623
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Fax |
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Provider Business Mailing Address
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Address Line | 732 THIMBLE SHOALS SUITE 302A, #1035
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City | NEWPORT NEWS
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State | VA
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Zip | 23606
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Country | US
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Telephone | 757-633-4623
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHARECA AKINES
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Credential | LPC
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Telephone | 757-633-4623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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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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