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General NPI Number Information
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NPI Number | 1619758588
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Entity Type | Organization
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Legal Business Name | CAVANY THERAPY, PLLC
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Dates
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Enumeration Date | 10/09/2023
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 1632 BOLES PL
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-5641
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Country | US
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Telephone | 804-972-4868
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Fax |
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Provider Business Mailing Address
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Address Line | 2820 SELWYN AVE STE 130-681
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City | CHARLOTTE
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State | NC
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Zip | 28209-1785
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Country | US
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Telephone | 704-268-9104
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Fax | 704-705-8795
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. PAMELA G CREPPS
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Credential | LCSW
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Telephone | 704-268-9104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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