Provider Demographics
NPI:1245724707
Name:RESILIENCE COUNSELING & SOCIAL SKILLS CENTER LLC
Entity type:Organization
Organization Name:RESILIENCE COUNSELING & SOCIAL SKILLS CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/LPC
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:MEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MS,LPC
Authorized Official - Phone:540-699-0226
Mailing Address - Street 1:6524 WOODLAKE VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2200
Mailing Address - Country:US
Mailing Address - Phone:540-699-0226
Mailing Address - Fax:540-699-0224
Practice Address - Street 1:6524 WOODLAKE VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2200
Practice Address - Country:US
Practice Address - Phone:540-699-0226
Practice Address - Fax:540-699-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty