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General NPI Number Information
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NPI Number | 1174210835
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Entity Type | Organization
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Legal Business Name | BACK TO BASICS COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 04/21/2023
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 4606 WESTGROVE CT STE A
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-5414
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Country | US
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Telephone | 757-816-2174
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Fax |
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Provider Business Mailing Address
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Address Line | 909 EWELL RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-4801
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Country | US
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Telephone | 757-816-2174
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BARBARA TERESE BEATTY
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Credential | LPC, NCC, CSAC
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Telephone | 757-816-2174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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