| Brightstar Counseling Services Pllc | |
|
213 Research Dr Ste 101 Chesapeake VA 23320-5996 | |
| (757) 737-2898 | |
| Not Available |
| Full Name | Brightstar Counseling Services Pllc |
|---|---|
| Speciality | Counselor |
| Location | 213 Research Dr Ste 101, Chesapeake, Virginia |
| Authorized Official Name and Position | Richard F Tavolacci (PROVIDER) |
| Authorized Official Contact | 7577372898 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brightstar Counseling Services Pllc Po Box 1776 Chesapeake VA 23327-1776 Ph: (757) 737-2898 | Brightstar Counseling Services Pllc 213 Research Dr Ste 101 Chesapeake VA 23320-5996 Ph: (757) 737-2898 |
| NPI Number | 1619697596 |
|---|---|
| Provider Enumeration Date | 08/31/2022 |
| Last Update Date | 08/31/2022 |
| Certification Date | 08/31/2022 |
| Medicare PECOS PAC ID | 3274972773 |
|---|---|
| Medicare Enrollment ID | O20240417000655 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619697596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Richard Frank Tavolacci |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861598120 PECOS PAC ID: 4183063688 Enrollment ID: I20240417000732 |
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