Provider Demographics
NPI:1225790926
Name:BBC COUNSELING AND SUPPORT SERVICES, LLC
Entity Type:Organization
Organization Name:BBC COUNSELING AND SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:BURRUSS
Authorized Official - Last Name:CHAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-550-1684
Mailing Address - Street 1:324 MAIN ST UNIT 466
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20725-7520
Mailing Address - Country:US
Mailing Address - Phone:301-720-0198
Mailing Address - Fax:301-288-1451
Practice Address - Street 1:6391 ROWANBERRY DR APT 414
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-7032
Practice Address - Country:US
Practice Address - Phone:301-720-0198
Practice Address - Fax:301-288-1451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-10
Last Update Date:2021-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty