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General NPI Number Information
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NPI Number | 1437005071
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Entity Type | Organization
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Legal Business Name | COMMUNITY INVOLVEMENT SERVICES. LLC
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Dates
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Enumeration Date | 03/06/2026
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 401 ROBERTS AVE APT 910
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City | PETERSBURG
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State | VA
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Zip | 23805-2478
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Country | US
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Telephone | 804-618-4942
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Fax | 804-618-4942
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Provider Business Mailing Address
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Address Line | 401 ROBERTS AVE APT 910
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City | PETERSBURG
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State | VA
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Zip | 23805-2478
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Country | US
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Telephone | 804-618-4942
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Fax | 804-618-4942
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Authorized Official
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Title or Position | OWNER
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Name | TAMARA RENEE WYCHE
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Credential |
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Telephone | 804-618-4942
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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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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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