Provider Demographics
NPI: | 1427120070 |
---|---|
Name: | VIRGINIA COUNSELING AND COMMUNITY DEVELOPMENT |
Entity type: | Organization |
Organization Name: | VIRGINIA COUNSELING AND COMMUNITY DEVELOPMENT |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | TEVAR |
Authorized Official - Middle Name: | MARKEL |
Authorized Official - Last Name: | ARCHER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MED |
Authorized Official - Phone: | 804-218-8182 |
Mailing Address - Street 1: | 3506 E BROAD ST |
Mailing Address - Street 2: | |
Mailing Address - City: | RICHMOND |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 23223-8004 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 804-218-8182 |
Mailing Address - Fax: | 480-287-8222 |
Practice Address - Street 1: | 3506 E BROAD ST |
Practice Address - Street 2: | |
Practice Address - City: | RICHMOND |
Practice Address - State: | VA |
Practice Address - Zip Code: | 23223-8004 |
Practice Address - Country: | US |
Practice Address - Phone: | 804-218-8182 |
Practice Address - Fax: | 480-287-8222 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-11-15 |
Last Update Date: | 2025-05-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251B00000X | Agencies | Case Management | ||
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 103TP0016X | Behavioral Health & Social Service Providers | Psychologist | Prescribing (Medical) | Group - Multi-Specialty |
No | 2084B0040X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry | Group - Multi-Specialty |
No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | |
No | 251S00000X | Agencies | Community/Behavioral Health | ||
No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health | |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness |