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General NPI Number Information
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NPI Number | 1326974635
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Entity Type | Organization
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Legal Business Name | AUTUMN SHORES CONSULTING & FAMILY SERVICES, LLC
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 2756 HEUTTE DRIVE
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City | NORFOLK
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State | VA
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Zip | 23518
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Country | US
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Telephone | 757-324-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 2756 HEUTTE DRIVE
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City | NORFOLK
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State | VA
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Zip | 23518
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Country | US
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Telephone | 757-735-0417
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. KRISTY TERESA MUNDON
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Credential | QMHP
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Telephone | 757-735-0417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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