NPIMap

Organization Active NPI

Realign Your Mind Counseling Services

  • Professional Counselor
  • Mechanicsville, VA
National Provider Identifier
1427638345
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
REALIGN YOUR MIND COUNSELING SERVICES
Practice address
6372 Mechanicsville Tpke Ste 111
Mechanicsville, VA 23111-4705
Phone
(804) 477-4808
Fax
(804) 592-6971
NPI assigned
Apr 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Authorized official

Name
Nicole Holler-Blackmon, LPCNPI 1518545649
Title
Licensed Professional Counselor
Phone
(804) 477-4808

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

6372 Mechanicsville Tpke Ste 111
Mechanicsville, VA 23111-4705

Mailing address

6372 Mechanicsville Tpke Ste 111
Mechanicsville, VA 23111-4705
Phone (804) 477-4808

Other practice location 1

812 Moorefield Park Dr Ste 210
North Chesterfield, VA 23236-3675
Phone (804) 592-6620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240216000743 VA Part B Supplier - Clinic/Group Practice 4385091172 Receives reassigned benefits from 11 practitioners
Practice locations: Mechanicsville, VA; North Chesterfield, VA

National Provider Directory

National Provider Directory

Locations

6372 Mechanicsville Tpke
Ste 111
Mechanicsville, VA 23111
Phone (804) 592-6620

6162 Mechanicsville Tpke
Mechanicsville, VA 23111
Phone (804) 592-6620

812 Moorefield Park Dr
Ste 210
North Chesterfield, VA 23236
Phone (804) 592-6620

Practitioners & affiliated clinicians

Practitioners 12

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": "1618272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773705600000",
    "number": "1427638345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6372 MECHANICSVILLE TPKE STE 111",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231114705",
            "telephone_number": "804-477-4808",
            "fax_number": "804-592-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6372 MECHANICSVILLE TPKE STE 111",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231114705",
            "telephone_number": "804-477-4808",
            "fax_number": "804-592-6971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "812 Moorefield Park Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "North Chesterfield",
            "state": "VA",
            "postal_code": "232363675",
            "country_code": "US",
            "telephone_number": "804-592-6620",
            "fax_number": "804-592-6971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REALIGN YOUR MIND COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-13",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A",
        "authorized_official_last_name": "HOLLER-BLACKMON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "804-477-4808",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.