Healthcare Provider Details

I. General information

NPI: 1689227332
Provider Name (Legal Business Name): ZOE MICAELA PERALTA-PAGE LMHC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH VA
23452-7332
US

IV. Provider business mailing address

780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH VA
23452-7332
US

V. Phone/Fax

Practice location:
  • Phone: 571-207-6246
  • Fax: 571-888-3303
Mailing address:
  • Phone: 571-207-6256
  • Fax: 571-888-3303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2023048392
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number133289
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61351452
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC015709
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14204606-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: