MEDICARE: ASCENSION ADDICTION & RECOVERY 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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1912830191
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCENSION ADDICTION & RECOVERY LLC.

Provider Business Mailing Address
First Line	:	6477 COLLEGE PARK SQ STE 124
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-3611
Country	:	US
Telephone Number	:	757-977-8968
Fax Number	:	757-257-6800

Provider Business Practice Location Address
First Line	:	6477 COLLEGE PARK SQ STE 124
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-3611
Country	:	US
Telephone Number	:	757-977-8968
Fax Number	:	757-257-6800

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	CYNIAH SAMMS
Credential	:
Telephone Number	:	757-977-8968

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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