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General NPI Number Information
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NPI Number | 1245072503
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Entity Type | Organization
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Legal Business Name | 180 COUNSELING INC.
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Dates
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Enumeration Date | 06/08/2024
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Last Update Date | 06/08/2024
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Provider Practice Location Address
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Address Line | 999 WATERSIDE DR
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City | NORFOLK
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State | VA
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Zip | 23510-3300
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Country | US
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Telephone | 757-977-8455
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Fax | 757-765-6450
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Provider Business Mailing Address
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Address Line | 2921 REPLICA LN
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City | PORTSMOUTH
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State | VA
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Zip | 23703-5218
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Country | US
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Telephone | 757-553-2352
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Fax | 757-765-6450
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. ANGEL MARIE BUNTON
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Credential | LCSW
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Telephone | 757-553-2352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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