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General NPI Number Information
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NPI Number | 1437795945
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Entity Type | Organization
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Legal Business Name | COMMONWEALTH COUNSELING AGENCY LLC
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Dates
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Enumeration Date | 11/19/2019
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 138 S ROSEMONT RD STE 208
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4336
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Country | US
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Telephone | 757-652-3280
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Fax | 757-707-8565
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Provider Business Mailing Address
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Address Line | 138 S ROSEMONT RD STE 208
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4336
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Country | US
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Telephone | 757-652-3280
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Fax | 757-707-8565
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Authorized Official
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Title or Position | CEO
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Name | MS. NATASHA ROBINSON
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Credential | MA, QMHP
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Telephone | 757-652-3280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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