| H.o.p.e. Family Support Services, Inc | |
|
291 Independence Blvd Ste 532 Virginia Beach VA 23462-5473 | |
| (757) 962-6889 | |
| (757) 962-6889 |
| Full Name | H.o.p.e. Family Support Services, Inc |
|---|---|
| Speciality | Counselor |
| Location | 291 Independence Blvd Ste 532, Virginia Beach, Virginia |
| Authorized Official Name and Position | Kimberly Penerton (LPC) |
| Authorized Official Contact | 7579626889 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| H.o.p.e. Family Support Services, Inc 291 Independence Blvd Ste 532 Virginia Beach VA 23462-5473 Ph: (757) 962-6889 | H.o.p.e. Family Support Services, Inc 291 Independence Blvd Ste 532 Virginia Beach VA 23462-5473 Ph: (757) 962-6889 |
| NPI Number | 1235646043 |
|---|---|
| Provider Enumeration Date | 01/02/2018 |
| Last Update Date | 03/29/2023 |
| Certification Date | 03/29/2023 |
| Medicare PECOS PAC ID | 7113463530 |
|---|---|
| Medicare Enrollment ID | O20240722003348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235646043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 922994 (Virginia) | Primary |
| Provider Name | Kimberly Penerton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821505637 PECOS PAC ID: 8022554443 Enrollment ID: I20240722003529 |
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