Provider Demographics
NPI:1023902368
Name:PIEDMONT COUNSELING COLLECTIVE, LLC
Entity type:Organization
Organization Name:PIEDMONT COUNSELING COLLECTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC, OWNER, CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:IWATSUBO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-928-1024
Mailing Address - Street 1:125 RIVERBEND DR STE 2
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8695
Mailing Address - Country:US
Mailing Address - Phone:434-989-3819
Mailing Address - Fax:
Practice Address - Street 1:125 RIVERBEND DR STE 2
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8695
Practice Address - Country:US
Practice Address - Phone:434-989-3819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty