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General NPI Number Information
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NPI Number | 1952880502
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Entity Type | Organization
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Legal Business Name | EXQUISITE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 4410 CLAIBORNE SQ E STE 343
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City | HAMPTON
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State | VA
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Zip | 23666-2071
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Country | US
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Telephone | 757-969-8584
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Fax | 757-826-4681
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Provider Business Mailing Address
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Address Line | 9 CINDY CT
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City | HAMPTON
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State | VA
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Zip | 23666-5632
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Country | US
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Telephone | 757-969-8584
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Fax | 757-826-4681
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Authorized Official
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Title or Position | CEO/EXECUTIVE DIRECTOR
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Name | MRS. DIANE L DAVIS
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Credential | M.S., QMHP-A/C
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Telephone | 757-969-8584
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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 | 130655
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License Number State | VA
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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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