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NPI 1861945180

NPI 1861945180 : PINNACLE ONE COUNSELING & CONSULTING, LLC : RICHMOND, VA

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General NPI Number Information
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    NPI Number           |    1861945180
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    Entity Type          |    Organization 
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    Legal Business Name  |    PINNACLE ONE COUNSELING & CONSULTING, LLC 
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Dates
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    Enumeration Date     |    08/03/2016
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    Last Update Date     |    08/03/2016
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Provider Practice Location Address
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    Address Line         |    7913 CAPISTRANO DR 
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    City                 |    RICHMOND
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    State                |    VA
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    Zip                  |    23227-2105
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    Country              |    US
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    Telephone            |    804-304-8189
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7913 CAPISTRANO DR 
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    City                 |    RICHMOND
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    State                |    VA
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    Zip                  |    23227-2105
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    Country              |    US
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    Telephone            |    804-304-8189
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER/LIC. CLINICAL SOCIAL WORKER
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    Name                 |    DR. PRICE  DAVIS 
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    Credential           |    LCSW
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    Telephone            |    804-304-8189
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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       |    0904007419
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    License Number State |    VA
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