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General NPI Number Information
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NPI Number | 1902784143
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Entity Type | Organization
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Legal Business Name | TRANSCVERSE LLC
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 3012 PARKSIDE CIR
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City | SUFFOLK
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State | VA
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Zip | 23435-3378
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Country | US
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Telephone | 757-354-2075
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Fax |
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Provider Business Mailing Address
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Address Line | 3012 PARKSIDE CIR
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City | SUFFOLK
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State | VA
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Zip | 23435-3378
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAILA NICOLE LAXA
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Credential | LPC, PHD, MA
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Telephone | 757-383-5432
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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 |
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License Number State |
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