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General NPI Number Information
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NPI Number | 1851779276
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Entity Type | Organization
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Legal Business Name | VIRGINIA BEACH COUNSELING AND WELLNESS
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Dates
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Enumeration Date | 05/18/2015
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 1561 BRADFORD RD STE 104
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-4089
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Country | US
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Telephone | 757-409-7172
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Fax |
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Provider Business Mailing Address
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Address Line | 1561 BRADFORD RD STE 104
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-4089
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Country | US
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Telephone | 757-409-7172
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. NATALIE WINGFIELD
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Credential | LPC
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Telephone | 757-409-7172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904008066
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701005771
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License Number State | VA
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