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General NPI Number Information
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NPI Number | 1376813410
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Entity Type | Organization
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Legal Business Name | OYSTER POINT COUNSELING CENTER
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Dates
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Enumeration Date | 01/06/2012
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Last Update Date | 01/09/2012
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Provider Practice Location Address
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Address Line | 1 OLD OYSTER POINT RD SUITE 250
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-7121
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Country | US
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Telephone | 757-240-1067
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Fax | 757-659-0128
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Provider Business Mailing Address
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Address Line | PO BOX 2057
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City | YORKTOWN
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State | VA
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Zip | 23692
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Country | US
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Telephone | 757-240-1067
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Fax | 757-659-0128
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. TIMOTHY WILLIAM LATSKO
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Credential | LMFT, LPC
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Telephone | 757-240-1067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717001186
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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