Provider Demographics
NPI:1619798261
Name:RADICAL EMPATHY COUNSELING LLC
Entity type:Organization
Organization Name:RADICAL EMPATHY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEGAN-LISTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:540-414-2225
Mailing Address - Street 1:804 MOOREFIELD PARK DR STE 204
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3670
Mailing Address - Country:US
Mailing Address - Phone:804-372-3290
Mailing Address - Fax:
Practice Address - Street 1:804 MOOREFIELD PARK DR STE 204
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3670
Practice Address - Country:US
Practice Address - Phone:804-372-3290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health