Provider Demographics
NPI:1437448982
Name:COUNSELING ALLIANCE OF VIRGINIA LLC
Entity Type:Organization
Organization Name:COUNSELING ALLIANCE OF VIRGINIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CASH
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-560-3129
Mailing Address - Street 1:6705 N GRAND BROOK CIR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4160
Mailing Address - Country:US
Mailing Address - Phone:804-560-3129
Mailing Address - Fax:
Practice Address - Street 1:6705 N GRAND BROOK CIR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4160
Practice Address - Country:US
Practice Address - Phone:804-560-3129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.07002081041C0700X
VA09040068281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty