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General NPI Number Information
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NPI Number | 1184201055
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Entity Type | Organization
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Legal Business Name | COUNSELING CRADLE, LLC
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 4736 MICHAUX DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-3228
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Country | US
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Telephone | 850-530-3807
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Fax |
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Provider Business Mailing Address
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Address Line | 4736 MICHAUX DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-3228
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Country | US
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Telephone | 850-530-3807
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. HEATHER ANN COSIMO
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Credential | LMHC
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Telephone | 850-530-3807
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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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