| Living Waters Therapeutic Alliance | |
|
2570 River Watch Dr Suffolk VA 23434-8669 | |
| (757) 270-3976 | |
| Not Available |
| Full Name | Living Waters Therapeutic Alliance |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2570 River Watch Dr, Suffolk, Virginia |
| Authorized Official Name and Position | Charlena Judith Catherine Correll (DIRECTOR) |
| Authorized Official Contact | 7574057519 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Waters Therapeutic Alliance 2570 River Watch Dr Suffolk VA 23434-8669 Ph: (757) 270-3976 | Living Waters Therapeutic Alliance 2570 River Watch Dr Suffolk VA 23434-8669 Ph: (757) 270-3976 |
| NPI Number | 1174207609 |
|---|---|
| Provider Enumeration Date | 06/14/2023 |
| Last Update Date | 06/14/2023 |
| Certification Date | 06/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174207609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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