Provider Demographics
NPI:1063952844
Name:PELORUS COUNSELING AND CONSULTING, LLC
Entity type:Organization
Organization Name:PELORUS COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, CCMHC
Authorized Official - Phone:540-371-3412
Mailing Address - Street 1:3306 BOURBON ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-7311
Mailing Address - Country:US
Mailing Address - Phone:540-371-3412
Mailing Address - Fax:540-479-8237
Practice Address - Street 1:3306 BOURBON ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7311
Practice Address - Country:US
Practice Address - Phone:540-371-3412
Practice Address - Fax:540-479-8237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005985101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty