MEDICARE: THREATT COUNSELING PLLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1639900053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THREATT COUNSELING PLLC

Provider Business Mailing Address
First Line	:	7639 HULL STREET RD STE 201204
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-6438
Country	:	US
Telephone Number	:	804-982-6430
Fax Number	:

Provider Business Practice Location Address
First Line	:	13201 NW FWY STE 800
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-6157
Country	:	US
Telephone Number	:	804-982-6430
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CHARITA THREATT
Credential	:	LPC
Telephone Number	:	804-982-6430

Provider Enumeration Date	:	08/08/2024
Last Update Date	:	05/06/2025

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