Healthcare Provider Details

I. General information

NPI: 1316321128
Provider Name (Legal Business Name): LATCH KEY PROJECTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2015
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1157 S MILITARY HWY SUITE 202-B
CHESAPEAKE VA
23320-2352
US

IV. Provider business mailing address

17577 BEALE PLACE DR
WINDSOR VA
23487-8345
US

V. Phone/Fax

Practice location:
  • Phone: 757-424-2357
  • Fax: 757-424-2316
Mailing address:
  • Phone: 757-424-2357
  • Fax: 757-424-2316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0710101904
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701000838
License Number StateVA

VIII. Authorized Official

Name: MARY PATRICIA BILLS
Title or Position: CEO
Credential: CSAC
Phone: 757-424-2357