Healthcare Provider Details

I. General information

NPI: 1982819751
Provider Name (Legal Business Name): STEPHANIE CHRISTINE OHARA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1092 LASKIN RD SUITE 100
VIRGINIA BEACH VA
23451-6362
US

IV. Provider business mailing address

2725 SHORE DR
VIRGINIA BEACH VA
23451-1335
US

V. Phone/Fax

Practice location:
  • Phone: 757-620-6559
  • Fax: 757-422-4162
Mailing address:
  • Phone: 757-620-6559
  • Fax: 757-422-4162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701002817
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: