| Cccs & Associates Llc | |
|
708 S Rosemont Rd Ste 203 Virginia Beach VA 23452-4061 | |
| (757) 431-0105 | |
| Not Available |
| Full Name | Cccs & Associates Llc |
|---|---|
| Speciality | Counselor |
| Location | 708 S Rosemont Rd Ste 203, Virginia Beach, Virginia |
| Authorized Official Name and Position | Dana Elizabeth Woerner (DIRECTOR OF OUTPATIENT) |
| Authorized Official Contact | 7574310105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cccs & Associates Llc 708 S Rosemont Rd Ste 203 Virginia Beach VA 23452-4061 Ph: () - | Cccs & Associates Llc 708 S Rosemont Rd Ste 203 Virginia Beach VA 23452-4061 Ph: (757) 431-0105 |
| NPI Number | 1124542949 |
|---|---|
| Provider Enumeration Date | 08/02/2017 |
| Last Update Date | 06/22/2023 |
| Certification Date | 06/22/2023 |
| Medicare PECOS PAC ID | 4183073513 |
|---|---|
| Medicare Enrollment ID | O20231212000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124542949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Maurice Shane Etter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053821884 PECOS PAC ID: 8527325000 Enrollment ID: I20171208002124 |
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