Provider Demographics
NPI:1952862831
Name:CJ COUNSELING AND CONSULTING SERVICES, LLC
Entity Type:Organization
Organization Name:CJ COUNSELING AND CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARESE
Authorized Official - Middle Name:LAKISA
Authorized Official - Last Name:JOSIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-613-8801
Mailing Address - Street 1:500 WASHINGTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-3508
Mailing Address - Country:US
Mailing Address - Phone:757-613-8801
Mailing Address - Fax:
Practice Address - Street 1:500 WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-3508
Practice Address - Country:US
Practice Address - Phone:757-613-8801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1245666288OtherNPI