Provider Demographics
NPI:1518264993
Name:PROGRESSIVE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:PROGRESSIVE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BAFFOUR
Authorized Official - Middle Name:EDUSEI
Authorized Official - Last Name:OPOKU
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:757-469-0517
Mailing Address - Street 1:1908 CAPEL MANOR WAY
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-7747
Mailing Address - Country:US
Mailing Address - Phone:757-469-0517
Mailing Address - Fax:757-368-5343
Practice Address - Street 1:1908 CAPEL MANOR WAY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-7747
Practice Address - Country:US
Practice Address - Phone:757-469-0517
Practice Address - Fax:757-368-5343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-20
Last Update Date:2011-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1580253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care