MEDICARE: COMPREHENSIVE LIFE SOLUTIONS

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	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	1041C0700X	Clinical Social Worker	0904008843	VA
3	261QM0850X	Adult Mental Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417442856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE LIFE SOLUTIONS

Provider Business Mailing Address
First Line	:	PO BOX 2904
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23327-2904
Country	:	US
Telephone Number	:	757-410-2566
Fax Number	:

Provider Business Practice Location Address
First Line	:	138 S ROSEMONT RD STE 209
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-4366
Country	:	US
Telephone Number	:	757-410-2566
Fax Number	:	888-374-6910

Authorized Official
Title or Position	:	CEO
Name	:	TIFFANY SINCENO
Credential	:	LCSW
Telephone Number	:	757-410-2566

Provider Enumeration Date	:	06/27/2018
Last Update Date	:	05/19/2022

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Directions to “COMPREHENSIVE LIFE SOLUTIONS ” Practice Location

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