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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
VA | 010001625 | 05 | |
VA | LMFT | 0717001169 | 01 |
VA | LPC | 0701003466 | 01 |
Other Name | Type Code |
---|---|
Summit Counseling Services | Doing Business As Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
821 W 21st St Ste 209, Norfolk, VA 235171500 | 7572801777 | 7575853521 |
Street Address |
957 W 21ST ST STE L |
City | NORFOLK |
State | VA |
Zip Code | 23517-1536 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164948535 | Honey Behavioral Therapy | Behavioral Analyst | 520 W. 21st Street, Suite G2-407, Norfolk, VA 23517 | 2017-08-17 |
1245638899 | Americare Plus, LLC. | In Home Supportive Care | 2200 Colonial Avenue, Suite 15, Norfolk, VA 23517 | 2014-12-15 |
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 |
1265568026 | Norfolk Integrative Manual Therapy | Physical Therapist | 350 22 St W., Suite 108, Norfolk, VA 23517 | 2007-02-26 |
1528133436 | Krysia B Witkowski | Physical Therapist | 350 W 22nd St, Suite 108, Norfolk, VA 23517 | 2006-11-24 |
1699846121 | Orthopaedic Associates of Virginia, Ltd | Neuromusculoskeletal Medicine, Sports Medicine | 953b West 21st St, Virginia Beach, VA 23517 | 2006-11-13 |
Find all providers in zip 23517 |
Taxonomy Code | 101YP2500X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Professional |
Definition to come... |
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 |
Find all providers in NORFOLK |
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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.