Healthcare Provider Details

I. General information

NPI: 1912830191
Provider Name (Legal Business Name): ASCENSION ADDICTION & RECOVERY LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6477 COLLEGE PARK SQ STE 124
VIRGINIA BEACH VA
23464-3611
US

IV. Provider business mailing address

6477 COLLEGE PARK SQ STE 124
VIRGINIA BEACH VA
23464-3611
US

V. Phone/Fax

Practice location:
  • Phone: 757-977-8968
  • Fax: 757-257-6800
Mailing address:
  • Phone: 757-977-8968
  • Fax: 757-257-6800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: CYNIAH SAMMS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 757-977-8968