MEDICARE: NATIONAL COUNSELING GROUP, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	352	VA

General Provider Information

NPI Number	:	1578803516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL COUNSELING GROUP, INC

Provider Business Mailing Address
First Line	:	PO BOX 11247
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-1247
Country	:	US
Telephone Number	:	866-566-9624
Fax Number	:	804-359-1387

Provider Business Practice Location Address
First Line	:	707 GITTINGS ST STE 100
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23434-6101
Country	:	US
Telephone Number	:	757-847-9386
Fax Number	:	757-252-3272

Authorized Official
Title or Position	:	ADMINISTRATION COORDINATOR
Name	:	TAMMY SUE OAKES
Credential	:
Telephone Number	:	804-980-7219

Provider Enumeration Date	:	02/28/2013
Last Update Date	:	08/10/2022

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