Healthcare Provider Details

I. General information

NPI: 1316658644
Provider Name (Legal Business Name): TARYN'S COUNSELING AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2022
Last Update Date: 12/07/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5512 LONELEAF WAY
VIRGINIA BEACH VA
23462-5757
US

IV. Provider business mailing address

5512 LONELEAF WAY
VIRGINIA BEACH VA
23462-5757
US

V. Phone/Fax

Practice location:
  • Phone: 804-363-5359
  • Fax:
Mailing address:
  • Phone: 804-363-5359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TARYN O'SHEA
Title or Position: OWNER
Credential: LCSW
Phone: 804-363-5359