NPIMap

Organization Active NPI

Old Towne Counseling Services, LLC

  • Mental Health Counselor
  • Mechanicsville, VA
National Provider Identifier
1487855003
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701002806 Issued in VA
Legal business name
OLD TOWNE COUNSELING SERVICES, LLC
Practice address
7489 Right Flank Rd Ste 330
Mechanicsville, VA 23116-3845
Phone
(804) 398-8401
Fax
(804) 789-8881
NPI assigned
May 30, 2007
Last updated
Aug 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Authorized official

Name
Mr. Charles Fultz
Title
President
Phone
(804) 398-8401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 0701002806 VA Primary

Addresses

Primary practice location

7489 Right Flank Rd Ste 330
Mechanicsville, VA 23116-3845

Mailing address

7489 Right Flank Rd Ste 330
Mechanicsville, VA 23116-3845
Phone (804) 398-8401

Other names 1

  • na Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111011000695 VA Part B Supplier - Clinic/Group Practice 7618149865 Receives reassigned benefits from 34 practitioners
Practice locations: Mechanicsville, VA

National Provider Directory

National Provider Directory

Locations

6366 Mechanicsville Tpke
Ste 203
Mechanicsville, VA 23111

6372 Mechanicsville Tpke
Ste 112
Mechanicsville, VA 23111

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786406400000",
    "number": "1487855003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7489 RIGHT FLANK RD STE 330",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231163845",
            "telephone_number": "804-398-8401",
            "fax_number": "804-789-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7489 RIGHT FLANK RD STE 330",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231163845",
            "telephone_number": "804-398-8401",
            "fax_number": "804-789-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWNE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A",
        "authorized_official_last_name": "FULTZ",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-398-8401",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701002806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "na",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Aug 11, 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.