Provider Demographics
NPI:1457853152
Name:PERSONAL SOLUTIONS COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:PERSONAL SOLUTIONS COUNSELING SERVICES, LLC
Other - Org Name:PERSONAL SOLUTIONS COUNSELING SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:
Authorized Official - Last Name:BORREL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-304-6869
Mailing Address - Street 1:2817 N PARHAM RD STE 211
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4411
Mailing Address - Country:US
Mailing Address - Phone:804-658-5930
Mailing Address - Fax:804-658-5404
Practice Address - Street 1:2817 N PARHAM RD STE 211
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4411
Practice Address - Country:US
Practice Address - Phone:804-658-5930
Practice Address - Fax:804-658-5404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2574-03-001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1710423116Medicaid