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General NPI Number Information
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NPI Number | 1336698489
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Entity Type | Organization
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Legal Business Name | ABUNDANT COUNSELING SOLUTIONS
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Dates
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Enumeration Date | 09/30/2016
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Last Update Date | 10/03/2016
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Provider Practice Location Address
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Address Line | 4004 GENESEE PL 101
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City | LAKE RIDGE
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State | VA
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Zip | 22192-8303
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Country | US
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Telephone | 571-989-2284
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Fax | 571-526-5981
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Provider Business Mailing Address
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Address Line | 4004 GENESEE PL 101
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City | LAKE RIDGE
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State | VA
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Zip | 22192-8303
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Country | US
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Telephone | 571-989-2284
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Fax | 571-526-5981
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Authorized Official
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Title or Position | OWNER
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Name | MAKEYSHIA MAJOR
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Credential | LCSW
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Telephone | 808-343-4010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904007463
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License Number State | VA
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