Healthcare Provider Details

I. General information

NPI: 1235027137
Provider Name (Legal Business Name): LP PSYCH & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 LIBERTY WAY STE 200
VIRGINIA BEACH VA
23456-3496
US

IV. Provider business mailing address

2380 LIBERTY WAY STE 200
VIRGINIA BEACH VA
23456-3496
US

V. Phone/Fax

Practice location:
  • Phone: 757-356-2884
  • Fax: 888-236-1804
Mailing address:
  • Phone: 757-356-2884
  • Fax: 888-236-1804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. LORI PALCIC
Title or Position: OWNER
Credential:
Phone: 757-356-2884