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General NPI Number Information
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NPI Number | 1245724707
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Entity Type | Organization
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Legal Business Name | RESILIENCE COUNSELING & SOCIAL SKILLS CENTER LLC
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 6524 WOODLAKE VILLAGE CIR
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-2200
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Country | US
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Telephone | 540-699-0226
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Fax | 540-699-0224
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Provider Business Mailing Address
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Address Line | 6524 WOODLAKE VILLAGE CIR
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-2200
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Country | US
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Telephone | 540-699-0226
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Fax | 540-699-0224
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Authorized Official
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Title or Position | OWNER/LPC
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Name | MR. KARL GEORGE MEMMER
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Credential | MS,LPC
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Telephone | 540-699-0226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 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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