| Prince Psychotherapy | |
|
512 S Lynnhaven Road Ste 101 Virginia Beach VA 23452-6664 | |
| (757) 306-4232 | |
| (757) 306-4235 |
| Full Name | Prince Psychotherapy |
|---|---|
| Speciality | Social Worker |
| Location | 512 S Lynnhaven Road, Virginia Beach, Virginia |
| Authorized Official Name and Position | Michael S Prince (LCSW/OWNER) |
| Authorized Official Contact | 7573064232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prince Psychotherapy 512 S Lynnhaven Road Ste 101 Virginia Beach VA 23452-6664 Ph: (757) 306-4232 | Prince Psychotherapy 512 S Lynnhaven Road Ste 101 Virginia Beach VA 23452-6664 Ph: (757) 306-4232 |
| NPI Number | 1356035000 |
|---|---|
| Provider Enumeration Date | 06/06/2023 |
| Last Update Date | 06/06/2023 |
| Certification Date | 06/06/2023 |
| Medicare PECOS PAC ID | 5597124396 |
|---|---|
| Medicare Enrollment ID | O20230711001357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356035000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michael S Prince |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295753630 PECOS PAC ID: 6800063421 Enrollment ID: I20120124000095 |
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