| Agape Counseling & Therapeutic Services, Inc | |
|
3221 Commander Shepard Blvd Hampton VA 23666-1598 | |
| (757) 244-3500 | |
| (877) 468-5361 |
| Full Name | Agape Counseling & Therapeutic Services, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3221 Commander Shepard Blvd, Hampton, Virginia |
| Authorized Official Name and Position | Teisha Sparrow (CREDENTIALING SPEC) |
| Authorized Official Contact | 7572443500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Counseling & Therapeutic Services, Inc 3221 Commander Shepard Blvd Hampton VA 23666-1598 Ph: (757) 244-3500 | Agape Counseling & Therapeutic Services, Inc 3221 Commander Shepard Blvd Hampton VA 23666-1598 Ph: (757) 244-3500 |
| NPI Number | 1134148380 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 02/08/2021 |
| Certification Date | 02/08/2021 |
| Medicare PECOS PAC ID | 0244476174 |
|---|---|
| Medicare Enrollment ID | O20130423000003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134148380 | NPI | - | NPPES |
| Q59697C284 | Other | VA | MEDICARE PTAN |
| 13953971 | Other | VA | CAQH |
| 11526769 | Other | VA | CAQH |
| 8936358 | Medicaid | VA | |
| Q42793C284 | Other | VA | MEDICAARE PTAN |
| Q46363C284 | Other | VA | MEDICARE PTAN |
| Provider Name | Sherie Sims Mawusi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669539037 PECOS PAC ID: 2062658990 Enrollment ID: I20130423000005 |
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