Healthcare Provider Details

I. General information

NPI: 1093634297
Provider Name (Legal Business Name): RESTORE COUNSELING & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 VIRGINIA BEACH BLVD STE 102
VIRGINIA BEACH VA
23454-4533
US

IV. Provider business mailing address

2129 GENERAL BOOTH BLVD PMB 344, SUITE 103 PMB 344, SUITE 103
VIRGINIA BEACH VA
23454
US

V. Phone/Fax

Practice location:
  • Phone: 757-932-0587
  • Fax:
Mailing address:
  • Phone: 757-932-0587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JULIE SMEAD
Title or Position: OWNER
Credential: LPC
Phone: 757-502-3722