Provider Demographics
NPI:1013413160
Name:INNOVATIVE COUNSELING SOLUTIONS
Entity Type:Organization
Organization Name:INNOVATIVE COUNSELING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANIECE
Authorized Official - Middle Name:JANEE
Authorized Official - Last Name:WINFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LSATP, RPT
Authorized Official - Phone:757-842-0542
Mailing Address - Street 1:PO BOX 15664
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23328-5664
Mailing Address - Country:US
Mailing Address - Phone:757-842-0542
Mailing Address - Fax:
Practice Address - Street 1:118 GREAT BRIDGE BLVD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3902
Practice Address - Country:US
Practice Address - Phone:757-842-0542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health