Healthcare Provider Details

I. General information

NPI: 1558291054
Provider Name (Legal Business Name): THE NOVEMBER FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 TODDS LN STE 160
HAMPTON VA
23666-3196
US

IV. Provider business mailing address

1702 TODDS LN STE 160
HAMPTON VA
23666-3196
US

V. Phone/Fax

Practice location:
  • Phone: 757-722-1800
  • Fax: 757-722-1800
Mailing address:
  • Phone: 757-722-1800
  • Fax: 757-722-1800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: DR. BEONKO ALEJANDRO SAMPSON
Title or Position: FOUNDER
Credential: PSYD
Phone: 757-722-1800