| Lee Sparrow Haven | |
|
3608 Bosun Dr Chesapeake VA 23321-3310 | |
| (757) 828-6301 | |
| Not Available |
| Full Name | Lee Sparrow Haven |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3608 Bosun Dr, Chesapeake, Virginia |
| Authorized Official Name and Position | Adrienne Nicole Smith (FOUNDER AND EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7578286301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lee Sparrow Haven 3608 Bosun Dr Chesapeake VA 23321-3310 Ph: (757) 828-6301 | Lee Sparrow Haven 3608 Bosun Dr Chesapeake VA 23321-3310 Ph: (757) 828-6301 |
| NPI Number | 1740069731 |
|---|---|
| Provider Enumeration Date | 09/27/2023 |
| Last Update Date | 01/30/2025 |
| Certification Date | 01/30/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740069731 | NPI | - | NPPES |
| 30018117570001 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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