Provider Demographics
NPI:1134727522
Name:ASSESSMENT & COUNSELING OF WILLIAMSBURG PLC
Entity type:Organization
Organization Name:ASSESSMENT & COUNSELING OF WILLIAMSBURG PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, ATR
Authorized Official - Phone:757-284-4554
Mailing Address - Street 1:113 RUDDER CT
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5288
Mailing Address - Country:US
Mailing Address - Phone:757-284-4554
Mailing Address - Fax:757-808-5526
Practice Address - Street 1:1101 PROFESSIONAL DR STE C
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3301
Practice Address - Country:US
Practice Address - Phone:757-941-8182
Practice Address - Fax:757-500-0134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty