Intracoastal Counseling & Consulting, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

INTRACOASTAL COUNSELING & CONSULTING, PLLC

Practice address

12736 Petrel Xing
Midlothian, VA 23112-2959

Phone

(252) 571-7235

Fax

(252) 631-0344

NPI assigned

Jan 20, 2022

Last updated

Jan 20, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Temple B. Berry, LCSWNPI 1891249603

Title

President/Owner

Phone

(252) 571-7235

Specialties & licenses 1

Addresses

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.

• Temple B. Berry, MSW, LCSW

  • Clinical Social Worker
  • Midlothian, VA
  • NPI 1891249603
  NPD Authorized official

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1861144982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12736 PETREL XING",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122959",
            "telephone_number": "252-571-7235",
            "fax_number": "252-631-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12736 PETREL XING",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122959",
            "telephone_number": "252-571-7235",
            "fax_number": "252-631-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTRACOASTAL COUNSELING & CONSULTING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "TEMPLE",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "252-571-7235",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.