Healthcare Provider Details

I. General information

NPI: 1730840638
Provider Name (Legal Business Name): CHRISTOPHER SUTTON LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2022
Last Update Date: 01/04/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MEDICAL DR STE A&B
HAMPTON VA
23666-1769
US

IV. Provider business mailing address

600 MEDICAL DR STE A&B
HAMPTON VA
23666-1769
US

V. Phone/Fax

Practice location:
  • Phone: 757-788-0600
  • Fax:
Mailing address:
  • Phone: 757-788-0600
  • Fax: 757-788-0969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701009818
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: