Organization
COLONIAL COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE M WHITE PSYD, LPC, LSATP, CA (PRESIDENT, CO-OWNER)
(804) 706-1111
Entity
Organization
Contact information
Practice address
9844 LORI RD, SUITE 100, CHESTERFIELD, VA 23832-6691
(804) 706-1111
(804) 706-1185
Mailing address
9844 LORI RD, SUITE 100, CHESTERFIELD, VA 23832-6691
(804) 706-1111
(804) 706-1185
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1462
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010244765
—
VA
01
—
036516
VALUE OPTIONS
VA
01
—
188589
ANTHEM BLUE CROSS
VA
Enumeration date
03/05/2009
Last updated
03/31/2015
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