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General NPI Number Information
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NPI Number | 1740879683
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Entity Type | Organization
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Legal Business Name | GREAT BLUE COUNSELING SERVICES
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Dates
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Enumeration Date | 01/14/2021
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 2723 W GRACE ST
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City | RICHMOND
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State | VA
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Zip | 23220-1912
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Country | US
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Telephone | 804-401-6947
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Fax |
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Provider Business Mailing Address
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Address Line | 2723 W GRACE ST
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City | RICHMOND
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State | VA
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Zip | 23220-1912
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Country | US
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Telephone | 804-401-6947
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | TONYA LEA BEERS-WARMAN
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Credential | LPC
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Telephone | 804-401-6947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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