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Individual

HAL IRWIN IMBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
4825 S LABURNUM AVE, RICHMOND, VA 23231-2713
(804) 222-2607
(804) 236-9118
Mailing address
10299 WOODMAN RD, GLEN ALLEN, VA 23060-4419
(804) 727-8500
(804) 727-8580

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710001240
VA
101YP2500X
Professional Counselor
Primary
0701003786
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
083948M
SENTARA
VA
01
4945131
VIRGINIA PREMIER
VA
Enumeration date
02/15/2007
Last updated
01/09/2008
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