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General NPI Number Information
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NPI Number | 1982294880
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Entity Type | Organization
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Legal Business Name | PERSONAL INSIGHTS PSYCHOTHERAPY & ASSESSMENTS LLC
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 02/11/2021
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Provider Practice Location Address
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Address Line | 485 S INDEPENDENCE BLVD STE 104
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-1129
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Country | US
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Telephone | 757-574-0355
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Fax | 757-578-8398
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Provider Business Mailing Address
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Address Line | 485 S INDEPENDENCE BLVD STE 104
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-1129
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Country | US
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Telephone | 757-574-0355
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Fax | 757-578-8398
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. RENEE BRUSH
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Credential | PHD
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Telephone | 757-574-0355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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