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General NPI Number Information
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NPI Number | 1124676564
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Entity Type | Organization
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Legal Business Name | FEELING MOODY LLC
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 11/05/2021
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Provider Practice Location Address
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Address Line | 816 INDEPENDENCE BLVD STE 1A
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-6010
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Country | US
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Telephone | 757-955-4073
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Fax |
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Provider Business Mailing Address
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Address Line | 2461 OLD GREENBRIER RD
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City | CHESAPEAKE
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State | VA
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Zip | 23325-4935
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Country | US
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Telephone | 757-560-3160
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIEF EXECUTIVE OFFICER
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Name | MS. DYVERYNCE VAUGHAN
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Credential | LPC
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Telephone | 757-955-4073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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