MEDICARE: MS. RAMONA DOUTHIT LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0701004086	VA
2	103T00000X	Psychologist	701004086	VA

General Provider Information

NPI Number	:	1386798585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RAMONA DOUTHIT LPC

Provider Business Mailing Address
First Line	:	184 BUSINESS PARK DRIVE
Second Line	:	SUITE 200
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6533
Country	:	US
Telephone Number	:	757-466-3336
Fax Number	:	757-455-5750

Provider Business Practice Location Address
First Line	:	184 BUSINESS PARK DRIVE
Second Line	:	SUITE 200
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6533
Country	:	US
Telephone Number	:	757-466-3336
Fax Number	:	757-455-5750

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	09/30/2009

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