Provider Demographics
NPI:1184473597
Name:BUILDING INDIVIDUALS GRADUALLY COUNSELING SERVICES B.I.G LLC
Entity type:Organization
Organization Name:BUILDING INDIVIDUALS GRADUALLY COUNSELING SERVICES B.I.G LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KERSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-563-8873
Mailing Address - Street 1:2807 N PARHAM RD STE 320
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4458
Mailing Address - Country:US
Mailing Address - Phone:434-838-0705
Mailing Address - Fax:
Practice Address - Street 1:2807 N PARHAM RD STE 320
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4458
Practice Address - Country:US
Practice Address - Phone:434-838-0705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health