MEDICARE: ELEVEN59 COUNSELING AND CONSULTING PLLC

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

General Provider Information

NPI Number	:	1942155320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVEN59 COUNSELING AND CONSULTING PLLC

Provider Business Mailing Address
First Line	:	4663 HAYGOOD RD STE 205
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-5442
Country	:	US
Telephone Number	:	757-696-3344
Fax Number	:

Provider Business Practice Location Address
First Line	:	249 CENTRAL PARK AVENUE
Second Line	:	SUITE 300-156
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462
Country	:	US
Telephone Number	:	757-696-3344
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/LPC OWNER
Name	:	LISA COUNTS WOOLSTON
Credential	:
Telephone Number	:	757-696-3344

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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