Licensed Professional Counseling Services, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

LICENSED PROFESSIONAL COUNSELING SERVICES, LLC

Practice address

1545 Crossways Blvd
Chesapeake, VA 23320-0205

Phone

(757) 309-1405

NPI assigned

Aug 19, 2020

Organization subpart

No

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

Authorized official

Name

Kim Richardson

Title

Credentialing

Phone

(757) 907-2567

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1750993887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 CROSSWAYS BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200205",
            "telephone_number": "757-309-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 CROSSWAYS BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200205",
            "telephone_number": "757-309-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LICENSED PROFESSIONAL COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "757-907-2567"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.