| NPI | 1134148380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEISHA SPARROW Credentialing Spec 757-244-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health (Licence: VA 0904004904) | |
| 101YP2500X Counselor, Professional | |
| 103TC0700X Psychologist, Clinical | |
| 103TH0004X Psychologist, Health | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904004904) | |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904002584) | |
| 1041C0700X Social Worker, Clinical | |
| 172V00000X Community Health Worker | |
| 251S00000X (Licence: VA 0904004904) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2021-02-08 |