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Individual

DR. BRANDY KELLY RICHESON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, LPC

Contact information

Practice address
3101 AMERICAN LEGION RD STE 23, CHESAPEAKE, VA 23321-5655
(757) 483-2580
(757) 483-2939
Mailing address
4589 KENNEBECK AVE, NORFOLK, VA 23513-3678
(175) 721-8505

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701006615
VA
101YS0200X
School Counselor
0600883
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0701006615
LPC LICENSE
VA
Enumeration date
11/20/2018
Last updated
11/20/2018
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