Provider Demographics
NPI:1396525945
Name:NATIONWIDE COMMUNITY COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:NATIONWIDE COMMUNITY COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:DEVEL
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-218-1300
Mailing Address - Street 1:1148 LESLIE ANN DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-2200
Mailing Address - Country:US
Mailing Address - Phone:804-218-1300
Mailing Address - Fax:
Practice Address - Street 1:201 E RANDOLPH RD STE A
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2745
Practice Address - Country:US
Practice Address - Phone:804-218-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health