Provider Demographics
NPI:1740879683
Name:GREAT BLUE COUNSELING SERVICES
Entity type:Organization
Organization Name:GREAT BLUE COUNSELING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:BEERS-WARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-401-6947
Mailing Address - Street 1:2723 W GRACE ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-1912
Mailing Address - Country:US
Mailing Address - Phone:804-401-6947
Mailing Address - Fax:
Practice Address - Street 1:2723 W GRACE ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-1912
Practice Address - Country:US
Practice Address - Phone:804-401-6947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1679173603OtherNPPES