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General NPI Number Information
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NPI Number | 1679717052
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Entity Type | Organization
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Legal Business Name | RILEY COUNSELING AND CONSULTING PLC
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 11/03/2016
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Provider Practice Location Address
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Address Line | 5900 E VIRGINIA BEACH BLVD SUITE 201
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City | NORFOLK
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State | VA
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Zip | 23502-2530
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Country | US
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Telephone | 757-938-5379
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Fax | 757-802-9237
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Provider Business Mailing Address
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Address Line | 2537 HARRIS CREEK CT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-6817
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Country | US
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Telephone | 757-285-4413
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Fax | 757-401-6962
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Authorized Official
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Title or Position | OWNER
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Name | MRS. EBONIE LENISE WALKER
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Credential | LCSW
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Telephone | 757-285-4413
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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 |
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License Number State |
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