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General NPI Number Information
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NPI Number | 1942082466
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Entity Type | Organization
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Legal Business Name | WELLVIEW SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 10/18/2023
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 2217 COURTNEY AVE APT 2
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City | NORFOLK
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State | VA
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Zip | 23504-2625
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Country | US
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Telephone | 757-685-4666
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Fax | 757-257-8862
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Provider Business Mailing Address
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Address Line | 2217 COURTNEY AVE APT 2
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City | NORFOLK
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State | VA
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Zip | 23504-2625
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Country | US
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Telephone | 757-685-4666
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Fax | 757-257-8862
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Authorized Official
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Title or Position | OWNER
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Name | LINWOOD I WIGGINS II
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Credential |
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Telephone | 757-685-4666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health 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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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