Healthcare Provider Details

I. General information

NPI: 1447640016
Provider Name (Legal Business Name): PATRICIA CODY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 COTTONDALE PL
SUFFOLK VA
23435-3268
US

IV. Provider business mailing address

101 COTTONDALE PL
SUFFOLK VA
23435-3268
US

V. Phone/Fax

Practice location:
  • Phone: 757-277-5979
  • Fax: 888-816-7113
Mailing address:
  • Phone: 757-277-5979
  • Fax: 888-816-7113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701006018
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: