NPIMap

Organization Active NPI

108 Counseling, LLC

  • Clinical Social Worker
  • North Chesterfield, VA
National Provider Identifier
1053874370
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
108 COUNSELING, LLC
Doing business as
108 Counseling , LLC
Practice address
8710 Choctaw Rd Ste 6a
North Chesterfield, VA 23235-3472
Phone
(646) 256-5103
NPI assigned
Apr 12, 2019
Last updated
Apr 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Authorized official

Name
Stephanie McNamara
Title
Credentialing Manager
Phone
(804) 221-2042

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

8710 Choctaw Rd Ste 6a
North Chesterfield, VA 23235-3472

Mailing address

8710 Choctaw Rd Ste 6a
North Chesterfield, VA 23235-3472
Phone (646) 256-5103

Other identifiers 1

IdentifierTypeStateIssuer
1366985228MedicaidVA

Other names 1

  • 108 Counseling , LLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555027200000",
    "number": "1053874370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8710 CHOCTAW RD STE 6A",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232353472",
            "telephone_number": "646-256-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8710 CHOCTAW RD STE 6A",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232353472",
            "telephone_number": "646-256-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "108 COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A",
        "authorized_official_last_name": "MCNAMARA",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "804-221-2042"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366985228",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "108 Counseling , LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2019; 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.