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General NPI Number Information
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NPI Number | 1922630474
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Entity Type | Individual
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Provider Name | DORESCIA RACHELLE PAIGE-PERRY LPC
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Gender | Female
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 3101 AMERICAN LEGION RD STE 21B
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City | CHESAPEAKE
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State | VA
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Zip | 23321-5699
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Country | US
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Telephone | 757-750-0715
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Fax |
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Provider Business Mailing Address
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Address Line | 2538 SHAMROCK GARDEN RD
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City | CHESAPEAKE
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State | VA
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Zip | 23323-3757
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Country | US
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Telephone | 757-750-0715
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0701008932
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License Number State | VA
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