Organization
THERAPEUTIC LEARNING CONSORTIUM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVIN COLCLOUGH LPC (OWNER/CLINICAL DIRECTOR)
(803) 795-8604
Entity
Organization
Contact information
Practice address
8154 FOREST HILL AVE STE 2, NORTH CHESTERFIELD, VA 23235
(804) 234-3350
(804) 533-1459
Mailing address
8154 FOREST HILL AVE STE 2, NORTH CHESTERFIELD, VA 23235-3255
(804) 234-3350
(804) 533-1459
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
04/05/2019
Last updated
05/29/2019
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