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General NPI Number Information
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NPI Number | 1356837918
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Entity Type | Organization
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Legal Business Name | MISSION HARBOR COUNSELING LLC
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Dates
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Enumeration Date | 07/06/2018
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 309 LYNNHAVEN PKWY STE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7411
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Country | US
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Telephone | 757-330-8822
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Fax | 757-296-0012
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Provider Business Mailing Address
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Address Line | 309 LYNNHAVEN PKWY STE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7411
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Country | US
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Telephone | 757-330-8822
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Fax | 757-296-0012
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | RAMSEY GOSHERT
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Credential | LPC
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Telephone | 757-714-7817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701005221
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License Number State | VA
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