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Organization

COMMUNITY COUNSELING RESOURCES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN MADDOX (N/A)
(757) 488-4797
Entity
Organization

Contact information

Practice address
600 CRAWFORD ST STE 220, PORTSMOUTH, VA 23704-3820
(757) 488-4797
(757) 488-4716
Mailing address
600 CRAWFORD ST STE 220, PORTSMOUTH, VA 23704-3820
(757) 488-4797
(757) 488-4716

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821435694
VA
Enumeration date
12/21/2010
Last updated
07/29/2019
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