Healthcare Provider Details

I. General information

NPI: 1790062966
Provider Name (Legal Business Name): ANNA TIHOMIROVA M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 CAMBRIDGE DR
VIRGINIA BEACH VA
23454-3404
US

IV. Provider business mailing address

833 CAMBRIDGE DR
VIRGINIA BEACH VA
23454-3404
US

V. Phone/Fax

Practice location:
  • Phone: 757-348-7879
  • Fax:
Mailing address:
  • Phone: 757-348-7879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0701007017
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: