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General NPI Number Information
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NPI Number | 1467869362
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Entity Type | Organization
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Legal Business Name | MOUNT PLEASANT CLINICAL ASSOCIATES
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Dates
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Enumeration Date | 07/13/2014
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Last Update Date | 07/13/2014
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Provider Practice Location Address
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Address Line | 229 MOUNT PLEASANT RD
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City | CHESAPEAKE
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State | VA
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Zip | 23322-4157
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Country | US
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Telephone | 757-482-1075
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Fax | 757-547-3591
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Provider Business Mailing Address
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Address Line | 229 MOUNT PLEASANT RD
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City | CHESAPEAKE
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State | VA
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Zip | 23322-4157
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Country | US
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Telephone | 757-482-1075
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Fax | 757-547-3591
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Authorized Official
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Title or Position | OWNER
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Name | JOAN ENOS DUHAIME
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Credential | CSW
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Telephone | 757-482-1075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904001708
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License Number State | VA
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