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General NPI Number Information
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NPI Number | 1245828607
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Entity Type | Organization
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Legal Business Name | THE CLINICAL CONSULTING GROUP, LLC
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Dates
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Enumeration Date | 01/01/2021
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Last Update Date | 01/01/2021
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Provider Practice Location Address
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Address Line | 4005 POPLAR GROVE RD
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-4736
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Country | US
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Telephone | 804-476-2668
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Fax |
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Provider Business Mailing Address
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Address Line | 4005 POPLAR GROVE RD
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-4736
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | CATHERINE BECKER
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Credential | LPC
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Telephone | 703-987-5517
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 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 #4
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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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