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General NPI Number Information
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NPI Number | 1801363189
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Entity Type | Organization
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Legal Business Name | POSITIVE WELLNESS AND RECOVERY LLC
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Dates
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Enumeration Date | 10/25/2018
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Last Update Date | 10/25/2018
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Provider Practice Location Address
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Address Line | 5900 E VIRGINIA BEACH BLVD STE 302
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City | NORFOLK
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State | VA
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Zip | 23502-2488
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Country | US
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Telephone | 757-285-6055
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Fax |
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Provider Business Mailing Address
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Address Line | 732 EDEN WAY N # 185
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2798
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Country | US
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Telephone | 757-285-6055
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MS. DELESHIA WILLIAMS
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Credential |
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Telephone | 757-285-6055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | 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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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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