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General NPI Number Information
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NPI Number | 1194550764
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Entity Type | Organization
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Legal Business Name | MLP2 LLC
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Dates
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Enumeration Date | 09/04/2024
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 4164 VIRGINIA BEACH BLVD STE 202
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-1762
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Country | US
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Telephone | 757-306-4232
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Fax | 757-306-4235
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Provider Business Mailing Address
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Address Line | 305 BROOKE AVE APT 104
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City | NORFOLK
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State | VA
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Zip | 23510-1346
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Country | US
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Telephone | 757-288-7350
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEGAN LEE PARKER
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Credential | LCSW
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Telephone | 757-288-7350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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