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General NPI Number Information
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NPI Number | 1578908505
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Entity Type | Organization
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Legal Business Name | B& W SUPPORTIVE COUNSELING GROUP, LLC
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Dates
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Enumeration Date | 05/03/2013
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Last Update Date | 05/03/2013
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Provider Practice Location Address
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Address Line | 9737 GREENMEADOW CIR
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City | GLEN ALLEN
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State | VA
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Zip | 23060-3569
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Country | US
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Telephone | 804-497-6694
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Fax | 804-545-2382
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Provider Business Mailing Address
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Address Line | 9737 GREENMEADOWS CIRCLE
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City | RICHMOND
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State | VA
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Zip | 23060
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Country | US
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Telephone | 804-497-6694
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Fax | 804-545-2382
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Authorized Official
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Title or Position | CHIEF OPERATION OFFICER
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Name | MS. NAZARELL WILLIAMS
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Credential | MS LMHP-E
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Telephone | 804-497-6694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | VA
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