# SELF-EVOLUTION COUNSELING & CLINICAL CONSULTATION, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568258861
- **Authorized official:** ANDREA RENEA GREGG-MARTIN MA, LPC, LMHP (LPC/OWNER)
- **Authorized official phone:** (804) 252-1862

## Contact information

- **Practice address:** 700 E 6TH ST \# L, RICHMOND, VA 23224-5560
- **Practice address phone:** (804) 252-1862
- **Practice address fax:** (804) 655-6171
- **Mailing address:** 700 E 6TH ST \# L, RICHMOND, VA 23224-5560
- **Mailing address phone:** (804) 252-1862
- **Mailing address fax:** (804) 655-6171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | Yes |
| 101YP2500X | Professional Counselor | — | — | Yes |

## Other

- **Enumeration date:** 04/15/2025
- **Last updated:** 04/30/2025