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General NPI Number Information
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NPI Number | 1225790926
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Entity Type | Organization
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Legal Business Name | BBC COUNSELING AND SUPPORT SERVICES, LLC
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Dates
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Enumeration Date | 10/10/2021
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Last Update Date | 10/10/2021
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Provider Practice Location Address
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Address Line | 6391 ROWANBERRY DR APT 414
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City | ELKRIDGE
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State | MD
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Zip | 21075-7032
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Country | US
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Telephone | 301-720-0198
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Fax | 301-288-1451
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Provider Business Mailing Address
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Address Line | 324 MAIN ST UNIT 466
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City | LAUREL
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State | MD
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Zip | 20725-7520
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Country | US
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Telephone | 301-720-0198
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Fax | 301-288-1451
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRENDA BURRUSS CHAVIS
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Credential |
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Telephone | 404-550-1684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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