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General NPI Number Information
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NPI Number | 1194517433
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Entity Type | Organization
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Legal Business Name | BREAKTHROUGH COLLECTIVE LLC
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 6104 HARNESSMAKER CT APT 103
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464
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Country | US
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Telephone | 757-999-4072
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Fax |
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Provider Business Mailing Address
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Address Line | 3419 VIRGINIA BEACH BLVD # 5044
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452
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Country | US
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Telephone | 757-354-2316
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NIKELAH HUGHES
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Credential | LCSW
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Telephone | 757-999-4072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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