Provider Demographics
NPI:1306402367
Name:5 STAR COUNSELING, LLC
Entity Type:Organization
Organization Name:5 STAR COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:D'TREL
Authorized Official - Middle Name:TAZEWELL
Authorized Official - Last Name:HASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-801-4518
Mailing Address - Street 1:3314 LAWSON ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-1854
Mailing Address - Country:US
Mailing Address - Phone:804-801-4518
Mailing Address - Fax:804-275-6066
Practice Address - Street 1:4012 HAWKBILL CT
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23237-4336
Practice Address - Country:US
Practice Address - Phone:804-801-4518
Practice Address - Fax:804-275-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health