Organization
CONSULTING & COMMUNITY RESOURCES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY L JOHNSON (QDIP/ OWNER)
(757) 409-2851
Entity
Organization
Contact information
Practice address
1535 MT VERNON AVE, PORTSMOUTH, VA 23707-3511
(757) 409-2851
Mailing address
1535 MT VERNON AVE, PORTSMOUTH, VA 23707-3511
(757) 409-2851
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
08/02/2021
Last updated
09/06/2023
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