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General NPI Number Information
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NPI Number | 1003779521
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Entity Type | Organization
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Legal Business Name | MAROON MINDSET LLC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 430 CRAWFORD ST APT 308
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City | PORTSMOUTH
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State | VA
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Zip | 23704-3813
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Country | US
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Telephone | 757-472-8746
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Fax |
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Provider Business Mailing Address
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Address Line | 110 COLISEUM XING UNIT 656
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City | HAMPTON
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State | VA
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Zip | 23666-5971
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | RENEE DIONNE STAMPS
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Credential | LPC
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Telephone | 757-472-8746
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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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