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General NPI Number Information
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NPI Number | 1194923144
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE CENTER FOR PSYCHOTHERAPY
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 1015 EDEN WAY N SUITE D
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2787
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Country | US
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Telephone | 757-477-2153
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 EDEN WAY N SUITE D
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2787
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Country | US
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Telephone | 757-477-2153
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR/OWNER
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Name | MS. DONNA M. PARIS
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Credential | L.C.S.W.
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Telephone | 757-477-2153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904003177
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License Number State | VA
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