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General NPI Number Information
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NPI Number | 1962878322
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Entity Type | Organization
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Legal Business Name | CSS & ASSOCIATES LLC
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 302 TURNER RD STE J-K
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23225-6433
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Country | US
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Telephone | 804-651-0876
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Fax | 804-275-2340
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Provider Business Mailing Address
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Address Line | 7053 OMALLEY DR
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23234-2881
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Country | US
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Telephone | 804-651-0876
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Fax | 804-275-2340
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CORETHA MARIE CLAIBORN
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Credential | LSATP, CSAC
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Telephone | 804-855-8625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0718000231
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License Number State | VA
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