MEDICARE: ESTELA&ANNAMARIE INCORPORATED

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1760066336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESTELA&ANNAMARIE INCORPORATED

Provider Business Mailing Address
First Line	:	7141 NEWPORT AVE APT 302
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23505-3940
Country	:	US
Telephone Number	:	757-512-4456
Fax Number	:

Provider Business Practice Location Address
First Line	:	223 E CITY HALL AVE # 346
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-1724
Country	:	US
Telephone Number	:	907-545-8865
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NATALIE MCCOREY
Credential	:	LPC
Telephone Number	:	757-512-4456

Provider Enumeration Date	:	05/10/2021
Last Update Date	:	05/10/2021

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