Endurance Counseling And Supervision Services, Llc | |
324 Lynnhaven Dr Hampton VA 23666-2300 | |
(757) 964-9543 | |
(757) 964-9567 |
Full Name | Endurance Counseling And Supervision Services, Llc |
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Speciality | Social Worker |
Location | 324 Lynnhaven Dr, Hampton, Virginia |
Authorized Official Name and Position | Jamicia L Davis (CEO AND MENTAL HEALTH THERAPIST) |
Authorized Official Contact | 7577553423 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Endurance Counseling And Supervision Services, Llc 324 Lynnhaven Dr Hampton VA 23666-2300 Ph: (757) 755-3423 | Endurance Counseling And Supervision Services, Llc 324 Lynnhaven Dr Hampton VA 23666-2300 Ph: (757) 964-9543 |
NPI Number | 1225637218 |
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Provider Enumeration Date | 10/20/2020 |
Last Update Date | 02/20/2025 |
Certification Date | 02/20/2025 |
Medicare PECOS PAC ID | 0648652362 |
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Medicare Enrollment ID | O20220727003603 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225637218 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Jamicia Lanece Davis |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1528537271 PECOS PAC ID: 4082954862 Enrollment ID: I20190313001858 |
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