| Blakey Weaver Counseling Center Inc | |
|
129 N Saratoga St Ste 1 Suffolk VA 23434-5255 | |
| (757) 539-5353 | |
| (757) 539-5399 |
| Full Name | Blakey Weaver Counseling Center Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 129 N Saratoga St Ste 1, Suffolk, Virginia |
| Authorized Official Name and Position | Kawanna Evette Ward-hall (CHAIRMAN) |
| Authorized Official Contact | 7573950472 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blakey Weaver Counseling Center Inc 129 N Saratoga St Ste 1 Suffolk VA 23434-5255 Ph: (757) 539-5353 | Blakey Weaver Counseling Center Inc 129 N Saratoga St Ste 1 Suffolk VA 23434-5255 Ph: (757) 539-5353 |
| NPI Number | 1245791995 |
|---|---|
| Provider Enumeration Date | 03/26/2019 |
| Last Update Date | 09/06/2023 |
| Medicare PECOS PAC ID | 4284064981 |
|---|---|
| Medicare Enrollment ID | O20200421001004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245791995 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kawanna Evette Ward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043515331 PECOS PAC ID: 9830333822 Enrollment ID: I20130913000292 |
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