Provider Demographics
NPI:1184172413
Name:COMPREHENSIVE COUNSELING SOLUTIONS OF VIRGINIA,LLC
Entity type:Organization
Organization Name:COMPREHENSIVE COUNSELING SOLUTIONS OF VIRGINIA,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EURONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-621-4249
Mailing Address - Street 1:10109 KRAUSE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-6501
Mailing Address - Country:US
Mailing Address - Phone:804-621-4249
Mailing Address - Fax:804-295-5398
Practice Address - Street 1:10109 KRAUSE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6501
Practice Address - Country:US
Practice Address - Phone:804-621-4249
Practice Address - Fax:804-295-5398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2564251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health