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General NPI Number Information
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NPI Number | 1407365943
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Entity Type | Organization
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Legal Business Name | GIFT OF THERAPY AND CONSULTING, LLC
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Dates
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Enumeration Date | 09/27/2017
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Last Update Date | 09/27/2017
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Provider Practice Location Address
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Address Line | 317 OFFICE SQUARE LN STE B102
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3650
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Country | US
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Telephone | 757-419-1871
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Fax | 757-419-1871
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Provider Business Mailing Address
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Address Line | 4240 PORTSMOUTH BLVD STE 425
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City | CHESAPEAKE
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State | VA
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Zip | 23321-2129
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Country | US
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Telephone | 757-419-1871
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Fax | 757-419-1871
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Authorized Official
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Title or Position | OWNER
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Name | DOROTHY MOORE
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Credential | LPC, ACS
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Telephone | 757-419-1871
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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 | 0701005610
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License Number State | VA
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