NPIMap

Organization Active NPI

Colonial Counseling Center

  • Addiction (Substance Use Disorder) Counselor
  • Chesterfield, VA
National Provider Identifier
1497995260
Registry record updated Mar 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1462 Issued in VA
Legal business name
COLONIAL COUNSELING CENTER
Practice address
9844 Lori Rd
Suite 100
Chesterfield, VA 23832-6691
Phone
(804) 706-1111
Fax
(804) 706-1185
NPI assigned
Mar 5, 2009
Last updated
Mar 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2015

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

Authorized official

Name
Mr. George M White, PSYD, LPC, LSATP, CANPI 1659397362
Title
President, Co-Owner
Phone
(804) 706-1111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1462 VA Primary

Addresses

Primary practice location

9844 Lori Rd
Suite 100
Chesterfield, VA 23832-6691

Mailing address

9844 Lori Rd
Suite 100
Chesterfield, VA 23832-6691
Phone (804) 706-1111

Other identifiers 3

IdentifierTypeStateIssuer
010244765MedicaidVA
036516OtherVAVALUE OPTIONS
188589OtherVAANTHEM BLUE CROSS

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1497995260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9844 LORI RD",
            "address_2": "SUITE 100",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326691",
            "telephone_number": "804-706-1111",
            "fax_number": "804-706-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9844 LORI RD",
            "address_2": "SUITE 100",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326691",
            "telephone_number": "804-706-1111",
            "fax_number": "804-706-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-05",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT, CO-OWNER",
        "authorized_official_telephone_number": "804-706-1111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PSYD, LPC, LSATP, CA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "1462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010244765",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "036516",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "188589",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.