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General NPI Number Information
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NPI Number | 1144847948
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Entity Type | Organization
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Legal Business Name | VIRGINIA BEACH CLINICAL COUNSELING LLC
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Dates
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Enumeration Date | 06/29/2020
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Last Update Date | 10/20/2023
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Provider Practice Location Address
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Address Line | 4224 HOLLAND RD STE 106
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-1900
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Country | US
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Telephone | 757-320-5819
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Fax |
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Provider Business Mailing Address
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Address Line | 908 LA TIERRA CT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-6432
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Country | US
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Telephone | 757-285-2388
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Fax |
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Authorized Official
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Title or Position | OWNER/ PSYCHOTHERAPIST
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Name | KIMBERLY WILLETT
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Credential | LCSW
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Telephone | 757-285-2388
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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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