Provider Demographics
NPI:1114790490
Name:RADIANT INNOVATIONS COUNSELING SERVICES
Entity Type:Organization
Organization Name:RADIANT INNOVATIONS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARECA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-633-4623
Mailing Address - Street 1:732 THIMBLE SHOALS
Mailing Address - Street 2:SUITE 302A, #1035
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-633-4623
Mailing Address - Fax:
Practice Address - Street 1:732 THIMBLE SHOALS
Practice Address - Street 2:SUITE 302A, #1035
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-633-4623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health