Provider Demographics
NPI:1598900482
Name:COUNSELING AND ADVOCACY ASSC.
Entity Type:Organization
Organization Name:COUNSELING AND ADVOCACY ASSC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWN/PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMARZIO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-426-1419
Mailing Address - Street 1:10128 HULL STREET RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-3300
Mailing Address - Country:US
Mailing Address - Phone:804-744-1114
Mailing Address - Fax:804-893-3721
Practice Address - Street 1:10128 HULL STREET RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112
Practice Address - Country:US
Practice Address - Phone:804-744-1114
Practice Address - Fax:804-893-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1175--05-001101Y00000X
103K00000X
VA1175-05-01251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty