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General NPI Number Information
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NPI Number | 1598275059
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Entity Type | Organization
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Legal Business Name | UNVALED PSYCHOLOGICAL PLLC
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 420 N CENTER DR STE 239B
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City | NORFOLK
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State | VA
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Zip | 23502-0014
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Country | US
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Telephone | 757-282-6309
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Fax | 757-282-6309
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Provider Business Mailing Address
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Address Line | 420 N CENTER DR STE 239B
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City | NORFOLK
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State | VA
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Zip | 23502-0014
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Country | US
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Telephone | 757-282-6309
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Fax | 757-282-6309
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Authorized Official
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Title or Position | OWNER
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Name | SHANNON CUTSHALL
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Credential | PHD
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Telephone | 757-282-6309
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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 | 0701006669
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License Number State | VA
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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