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General NPI Number Information
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NPI Number | 1942033444
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Entity Type | Organization
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Legal Business Name | TAILORED HOLISTIC COUNSELING LLC
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 6601 IRONGATE SQ STE C
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23234-6077
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Country | US
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Telephone | 703-399-2197
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Fax |
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Provider Business Mailing Address
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Address Line | 9221 FOREST HILL AVE
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City | RICHMOND
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State | VA
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Zip | 23235-6876
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Country | US
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Telephone | 703-399-2197
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Fax | 703-544-4690
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DANIELLE THOMPSON
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Credential | LPC
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Telephone | 703-399-2197
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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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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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