MEDICARE: HIPPS FAMILY SERVICES LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904006563	VA

General Provider Information

NPI Number	:	1063866655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIPPS FAMILY SERVICES LLC.

Provider Business Mailing Address
First Line	:	5215 COLLEY AVE
Second Line	:	STE. 138
City	:	NORFOLK
State	:	VA
Zip	:	23508-2172
Country	:	US
Telephone Number	:	757-389-1890
Fax Number	:

Provider Business Practice Location Address
First Line	:	5215 COLLEY AVE
Second Line	:	STE. 138
City	:	NORFOLK
State	:	VA
Zip	:	23508-2172
Country	:	US
Telephone Number	:	757-389-1890
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CINSYEKA GRASONY
Credential	:
Telephone Number	:	804-518-6469

Provider Enumeration Date	:	04/20/2016
Last Update Date	:	11/06/2020

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