Provider Demographics
NPI:1417412818
Name:PERSEVERANCE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:PERSEVERANCE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIARA
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-509-4954
Mailing Address - Street 1:1376 OLD BRIDGE RD # 101-2
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2708
Mailing Address - Country:US
Mailing Address - Phone:757-509-4954
Mailing Address - Fax:
Practice Address - Street 1:1376 OLD BRIDGE RD # 101-2
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2708
Practice Address - Country:US
Practice Address - Phone:757-509-4954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-10
Last Update Date:2019-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health