| Virginia Beach Clinical Counseling Llc | |
|
4224 Holland Rd Ste 106 Virginia Beach VA 23452-1900 | |
| (757) 320-5819 | |
| Not Available |
| Full Name | Virginia Beach Clinical Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4224 Holland Rd Ste 106, Virginia Beach, Virginia |
| Authorized Official Name and Position | Kimberly Willett (OWNER/ PSYCHOTHERAPIST) |
| Authorized Official Contact | 7572852388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia Beach Clinical Counseling Llc 908 La Tierra Ct Virginia Beach VA 23456-6432 Ph: (757) 285-2388 | Virginia Beach Clinical Counseling Llc 4224 Holland Rd Ste 106 Virginia Beach VA 23452-1900 Ph: (757) 320-5819 |
| NPI Number | 1144847948 |
|---|---|
| Provider Enumeration Date | 06/29/2020 |
| Last Update Date | 10/20/2023 |
| Certification Date | 10/20/2023 |
| Medicare PECOS PAC ID | 7416377460 |
|---|---|
| Medicare Enrollment ID | O20201014000017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144847948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kimberly Vaughan Willett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366904385 PECOS PAC ID: 8325468374 Enrollment ID: I20201014000036 |
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