| Southside Services, Llc | |
|
1545 Crossways Blvd Ste 250 Chesapeake VA 23320-0218 | |
| (757) 309-1405 | |
| Not Available |
| Full Name | Southside Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1545 Crossways Blvd Ste 250, Chesapeake, Virginia |
| Authorized Official Name and Position | Annie J Scott (CEO) |
| Authorized Official Contact | 7573091405 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Services, Llc 1844 Burwillow Dr Virginia Beach VA 23464-8945 Ph: (757) 309-1405 | Southside Services, Llc 1545 Crossways Blvd Ste 250 Chesapeake VA 23320-0218 Ph: (757) 309-1405 |
| NPI Number | 1295211316 |
|---|---|
| Provider Enumeration Date | 07/11/2018 |
| Last Update Date | 07/11/2018 |
| Medicare PECOS PAC ID | 4789112921 |
|---|---|
| Medicare Enrollment ID | O20250115002204 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295211316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2356 (Virginia) | Primary |
| Provider Name | Annie Scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053923185 PECOS PAC ID: 4486182623 Enrollment ID: I20250115002459 |
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