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General NPI Number Information
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NPI Number | 1558759274
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Entity Type | Organization
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Legal Business Name | PASSION OF RESILIENCE COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 01/05/2015
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Last Update Date | 01/06/2015
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Provider Practice Location Address
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Address Line | 11835 CANON BLVD STE B102
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2570
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Country | US
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Telephone | 757-593-5085
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Fax | 757-484-3123
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Provider Business Mailing Address
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Address Line | 517 PEAFOWL CT
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City | SUFFOLK
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State | VA
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Zip | 23435-3332
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Country | US
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Telephone | 757-593-5085
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Fax | 757-484-3123
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. KRISTIN NEELY BARBEE
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Credential | PSY.D/LCP
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Telephone | 757-593-5085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 810004243
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License Number State | VA
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