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General NPI Number Information
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NPI Number | 1689207599
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Entity Type | Organization
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Legal Business Name | 3 KEYS COUNSELING & CONSULTING, LLC
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 3810 INDIAN RIVER RD UNIT 13074
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City | CHESAPEAKE
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State | VA
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Zip | 23325-1202
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Country | US
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Telephone | 757-276-1511
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Fax |
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Provider Business Mailing Address
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Address Line | 3810 INDIAN RIVER RD UNIT 13074
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City | CHESAPEAKE
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State | VA
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Zip | 23325-1202
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | TAKIYA TARLTON
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Credential |
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Telephone | 757-450-5873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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