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NPI Code Detail

MEDICARE: SEA LEVEL COUNSELING AND WELLNESS, LLC

MEDICARE: SEA LEVEL COUNSELING AND WELLNESS, LLC
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
11041C0700XClinical Social Worker0904007148VA

Other Identifiers

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

General Provider Information

NPI Number : 1861812026
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEA LEVEL COUNSELING AND WELLNESS, LLC
Provider Business Mailing Address
First Line : 2200 COLONIAL AVE STE 12
Second Line :
City : NORFOLK
State : VA
Zip : 23517-1919
Country : US
Telephone Number : 757-937-5780
Fax Number : 757-937-5781
Provider Business Practice Location Address
First Line : 2200 COLONIAL AVE STE 12
Second Line :
City : NORFOLK
State : VA
Zip : 23517-1919
Country : US
Telephone Number : 757-937-5780
Fax Number : 757-937-5781
Authorized Official
Title or Position : OWNER/PROVIDER
Name : MS. ABIGAIL MORGAN
Credential : LCSW
Telephone Number : 757-937-5780
Provider Enumeration Date : 04/25/2014
Last Update Date : 04/08/2019

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