MEDICARE: A NEW CYCLE COUNSELING SERVICES

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1831722032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A NEW CYCLE COUNSELING SERVICES

Provider Business Mailing Address
First Line	:	3934 FILBERT WAY
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-7512
Country	:	US
Telephone Number	:	678-852-0768
Fax Number	:

Provider Business Practice Location Address
First Line	:	3934 FILBERT WAY
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-7512
Country	:	US
Telephone Number	:	678-852-0768
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHARITA LYNN SELDEN
Credential	:	LPC
Telephone Number	:	678-852-0768

Provider Enumeration Date	:	02/15/2020
Last Update Date	:	02/15/2020

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