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General NPI Number Information
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NPI Number | 1003706102
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Entity Type | Organization
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Legal Business Name | SOPHIA SILLS-TAILOR, PH.D, LPC, PLLC
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 1300 DIAMOND SPRINGS RD STE 401
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-3632
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Country | US
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Telephone | 757-724-0980
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 DIAMOND SPRINGS RD STE 401
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-3632
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Country | US
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Telephone | 757-724-0980
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. SOPHIA C SILLS-TAILOR
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Credential | LPC
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Telephone | 757-724-0980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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