Healthcare Provider Details

I. General information

NPI: 1831035468
Provider Name (Legal Business Name): SEVEN AND MAE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 JOHNSTOWN CRES APT A
CHESAPEAKE VA
23322-5653
US

IV. Provider business mailing address

5 JOHNSTOWN CRES APT A
CHESAPEAKE VA
23322-5653
US

V. Phone/Fax

Practice location:
  • Phone: 757-998-1194
  • Fax:
Mailing address:
  • Phone: 757-998-1194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TRACIE LYNN KIPTOO
Title or Position: OWNER/CEO
Credential: LCSW
Phone: 757-998-1194