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General NPI Number Information
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NPI Number | 1518744663
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Entity Type | Organization
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Legal Business Name | SHOOTING STAR COUNSELING, LLC
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 5250 CHALLEDON DR STE 200
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6304
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Country | US
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Telephone | 757-406-1716
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Fax |
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Provider Business Mailing Address
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Address Line | 2613 ELON DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-4355
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Country | US
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Telephone | 757-406-1716
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAURA M SAMALYA
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Credential | LPC
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Telephone | 757-406-1716
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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 |
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License Number State |
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