Organization
ABUNDANT LIFE SERVICES, LLC
Active
Other names
Abundant Life Services, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SHANIKA HARRIS (EXECUTIVE DIRECTOR)
(757) 575-5535
Entity
Organization
Contact information
Practice address
1919 COMMERCE DR STE 315, HAMPTON, VA 23666-4298
(757) 204-5469
(757) 210-4330
Mailing address
1919 COMMERCE DR STE 315, HAMPTON, VA 23666-4298
(757) 204-5469
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
05/12/2020
Last updated
06/06/2024
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