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General NPI Number Information
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NPI Number | 1801968987
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Entity Type | Organization
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Legal Business Name | SOUTHSIDE COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 6072 GODWIN BLVD
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City | SUFFOLK
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State | VA
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Zip | 23432-1012
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Country | US
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Telephone | 757-255-2555
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Fax | 757-255-7009
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Provider Business Mailing Address
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Address Line | 6072 GODWIN BLVD PO BOX 2387
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City | SUFFOLK
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State | VA
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Zip | 23432-1012
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Country | US
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Telephone | 757-255-2555
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Fax | 757-255-7009
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHARON W KRUMPE
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Credential | LPC, LMFT
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Telephone | 757-255-2555
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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 | 0701003187
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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 | 0701002307
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 0810001984
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717001033
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701003999
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License Number State | VA
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