NPIMap

Organization Active NPI

Iasis Counseling and Consulting Services

  • Mental Health Counselor
  • Richmond, VA
National Provider Identifier
1013350552
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701004328 Issued in VA
Legal business name
IASIS COUNSELING AND CONSULTING SERVICES
Practice address
4609 W Broad St
Suite A2
Richmond, VA 23230-3205
Phone
(804) 355-2333
Fax
(804) 355-3540
NPI assigned
Apr 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Thea A Green, PH.D,, L.P.C.NPI 1346368636
Title
Ceo
Phone
(804) 882-6163

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 0701004328 VA
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 0701004328 VA Primary
Pastoral CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP1600X 0701004328 VA
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 0701004328 VA

Addresses

Primary practice location

4609 W Broad St
Suite A2
Richmond, VA 23230-3205

Mailing address

1351 Blackrock Dr
Richmond, VA 23225-4101
Phone (804) 882-6163

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1013350552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 BLACKROCK DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232254101",
            "telephone_number": "804-882-6163",
            "fax_number": "804-355-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 W BROAD ST",
            "address_2": "SUITE A2",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303205",
            "telephone_number": "804-355-2333",
            "fax_number": "804-355-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IASIS COUNSELING AND CONSULTING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-15",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "THEA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-882-6163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D,, L.P.C."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0701004328",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701004328",
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": "VA",
            "license": "0701004328",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004328",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.