Provider Demographics
NPI:1902413248
Name:NU VISION COUNSELING & CONSULTING SERVICES, LLC
Entity Type:Organization
Organization Name:NU VISION COUNSELING & CONSULTING SERVICES, LLC
Other - Org Name:DEENA TERRELL, LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-918-5572
Mailing Address - Street 1:11825 CHASE WELLESLEY DR APT 717
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7760
Mailing Address - Country:US
Mailing Address - Phone:804-918-5572
Mailing Address - Fax:888-348-3804
Practice Address - Street 1:11825 CHASE WELLESLEY DR
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-7760
Practice Address - Country:US
Practice Address - Phone:804-918-5572
Practice Address - Fax:888-348-3804
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEENA A TERRELL DBA DATS CCC SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-30
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904009847OtherVIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
NJ44SC05933600Medicaid
NJ44SC05933600OtherNEW JERSEY STATE BOARD OF SOCIAL WORK EXAMINERS
VA0904009847Medicaid