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General NPI Number Information
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NPI Number | 1952857153
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Entity Type | Organization
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Legal Business Name | BAY CONSULTING LLC
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/28/2016
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Provider Practice Location Address
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Address Line | 235 N. MAIN STREET
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City | KILMARNOCK
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State | VA
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Zip | 22482-8501
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Country | US
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Telephone | 804-436-7086
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Fax | 804-438-8102
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Provider Business Mailing Address
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Address Line | 139 JAMES LANE
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City | WEEMS
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State | VA
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Zip | 22576-2641
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Country | US
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Telephone | 804-436-7086
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Fax | 804-438-8102
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Authorized Official
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Title or Position | OWNER
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Name | BRENDA BURKHOLDER
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Credential | LPC
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Telephone | 804-436-7086
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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 | 0701005130
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License Number State | VA
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