Organization
INTRACOASTAL COUNSELING & CONSULTING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEMPLE B. BERRY LCSW (PRESIDENT/OWNER)
(252) 571-7235
Entity
Organization
Contact information
Practice address
12736 PETREL XING, MIDLOTHIAN, VA 23112-2959
(252) 571-7235
(252) 631-0344
Mailing address
12736 PETREL XING, MIDLOTHIAN, VA 23112-2959
(252) 571-7235
(252) 631-0344
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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