BOLD RULER, LLC


Address: 957 W 21st St Ste L, Norfolk, VA 23517-1536
Phone: 7572801777

BOLD RULER, LLC (NPI# 1316404544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1316404544
Entity Type Organization
Organization Name BOLD RULER, LLC
Other Organization Name SUMMIT COUNSELING SERVICES
Practice Address 957 W 21st St Ste L
Norfolk
VA 23517-1536
Mailing Address 214 Lenox Ave
Norfolk
VA 23503-3518
Practice Telephone 7572801777
Practice Fax Number 7575853521
Mailing Telephone 7574721379
Enumeration Date 2019-02-24
Last Update Date 2020-04-17
Authorized Official Name LAURA S. MALONEY (OWNER/CLINICIAN)
Authorized Official Telephone 7574721379
Authorized Official Credential LPC, LMFT
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101Y00000X Counselor Behavioral Health & Social Service Providers
N 1041C0700X Social Worker
Specialization: Clinical
Behavioral Health & Social Service Providers
N 106H00000X Marriage & Family Therapist Behavioral Health & Social Service Providers
Y 101YP2500X Counselor
Specialization: Professional
Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
VA 010001625 05
VA LMFT 0717001169 01
VA LPC 0701003466 01

Other Provider/Organization Names

Other Name Type Code
Summit Counseling Services Doing Business As Name - Organization

Provider Secondary Practice Location

Address Telephone Number Fax Number
821 W 21st St Ste 209, Norfolk, VA 235171500 7572801777 7575853521

Office Location

Street Address 957 W 21ST ST STE L
City NORFOLK
State VA
Zip Code 23517-1536

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1932458478 Carolyn Reed Hersh Counselor 117 W. 21st Street, Suite 206, Norfolk, VA 23517 2012-08-30
1487959342 Harris Teeter, LLC Pharmacy 1320 Colonial Avenue, Norfolk, VA 23517 2011-01-24
1912133406 Air Specialty Corp Contractor 121 East 25th St, Norfolk, VA 23517 2009-06-10
1578798849 East End Academy Inc Southside Clinic/Center 2607 Colonial Avenue, Norfolk, VA 23517 2009-05-15
1568682292 Jennifer S Derugen Midwife 1700 Hampton Blvd, Apt A, Norfolk, VA 23517 2007-04-26
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1528133436 Krysia B Witkowski Physical Therapist 350 W 22nd St, Suite 108, Norfolk, VA 23517 2006-11-24
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104446350 Octasia Nikkole Gainer Counselor 121 Hicks Ave, Norfolk, VA 23502-4612 2020-04-17
1972138055 Ashanti Newkirk Counselor 6330 N Center Dr Ste 13, Norfolk, VA 23502-4008 2020-03-09
1154967933 Leroyal Parker Counselor 3606 Hyde Cir, Norfolk, VA 23513-3548 2019-11-26
1922640598 Travis Pinner Counselor 6325 N Center Dr Bldg 18, Norfolk, VA 23502-4010 2019-10-15
1154974566 Human Care, LLC Counselor 1216 Granby St Ste 204, Norfolk, VA 23510-2622 2019-07-24
1013412824 Anchor Counseling, Pllc Counselor 819 W 21st St Ste 101-a, Norfolk, VA 23517-1539 2018-03-26
1902314313 Brittany Nicole Johnson Counselor 6350 Center Dr Ste 106, Norfolk, VA 23502-4107 2018-01-19
1215448899 Erin Nicole Freeman Counselor 861 Glenrock Rd Ste 200, Norfolk, VA 23502-3719 2017-10-23
1598275059 Unvaled Psychological Counselor 6387 Center Dr Ste 19, Norfolk, VA 23502-4109 2017-10-10
1467979351 Lakeshia Louise Perryman Counselor 6325 N. Center Drive, Bldg 18, Suite 208, Norfolk, VA 23502 2017-08-23
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Competitor

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City NORFOLK
Zip Code 23517

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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