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General NPI Number Information
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NPI Number | 1679925929
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Entity Type | Organization
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Legal Business Name | BEYOND THE BURDEN COUNSELING SERVICES
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 4310 INDIAN RIVER RD SUITE 4
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City | CHESAPEAKE
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State | VA
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Zip | 23325-3100
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Country | US
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Telephone | 757-773-9511
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Fax |
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Provider Business Mailing Address
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Address Line | 4310 INDIAN RIVER RD SUITE 4
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City | CHESAPEAKE
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State | VA
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Zip | 23325-3100
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Country | US
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Telephone | 757-773-9511
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MS. JONI SUE HURSEY-WINGATE
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Credential | L.P.C.
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Telephone | 757-773-9511
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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 | 0701004622
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License Number State | VA
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