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General NPI Number Information
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NPI Number | 1740647700
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Entity Type | Organization
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Legal Business Name | TLCOUNSELING, LLC
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 4509 WHITECHAPEL DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-6447
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Country | US
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Telephone | 757-460-4655
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Fax |
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Provider Business Mailing Address
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Address Line | 2220 KIRKBY LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-6975
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Country | US
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Telephone | 703-980-9205
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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 | KRISTINE U LARSON
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Credential | LPC
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Telephone | 703-980-9205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701003802
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License Number State | VA
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