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General NPI Number Information
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NPI Number | 1528689130
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Entity Type | Organization
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Legal Business Name | HEALTHY MIND COUNSELING & NUTRITION,LLC
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 02/11/2024
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Provider Practice Location Address
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Address Line | 733 THIMBLE SHOALS BLVD STE 170
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4260
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Country | US
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Telephone | 757-537-8224
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Fax | 757-260-4896
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Provider Business Mailing Address
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Address Line | 3575 BRIDGE RD STE 228
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City | SUFFOLK
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State | VA
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Zip | 23435-1800
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Country | US
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Telephone | 757-537-8224
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Fax | 757-260-4896
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Authorized Official
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Title or Position | OWNER
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Name | MISS KIMBERLY PARKER
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Credential | LCSW
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Telephone | 757-537-8224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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