| Beach Counseling Center Llc | |
|
1064 Laskin Rd Ste 14c Virginia Beach VA 23451-6337 | |
| (757) 233-1500 | |
| (757) 222-3833 |
| Full Name | Beach Counseling Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 1064 Laskin Rd Ste 14c, Virginia Beach, Virginia |
| Authorized Official Name and Position | Lou Phillips (ADMINISTRATOR) |
| Authorized Official Contact | 7576513003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beach Counseling Center Llc 817 Linkhorn Dr Virginia Beach VA 23451-3920 Ph: (757) 651-3003 | Beach Counseling Center Llc 1064 Laskin Rd Ste 14c Virginia Beach VA 23451-6337 Ph: (757) 233-1500 |
| NPI Number | 1336510254 |
|---|---|
| Provider Enumeration Date | 10/19/2015 |
| Last Update Date | 07/14/2023 |
| Certification Date | 07/14/2023 |
| Medicare PECOS PAC ID | 5496172983 |
|---|---|
| Medicare Enrollment ID | O20200828001869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336510254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0701004521 (Virginia) | Primary |
| 1041C0700X | Social Worker - Clinical | 0904009182 (Virginia) | Secondary |
| Provider Name | Deborah B Reese |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891749644 PECOS PAC ID: 6305879511 Enrollment ID: I20050916000651 |
| Provider Name | Thomas K Tsao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659343556 PECOS PAC ID: 6305742032 Enrollment ID: I20110121000334 |
| Provider Name | Joyce H Tsao |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528032471 PECOS PAC ID: 2062680218 Enrollment ID: I20110714000507 |
| Provider Name | Mark A Warren |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154360329 PECOS PAC ID: 9739355132 Enrollment ID: I20120106000404 |
| Provider Name | Courtney F Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275074908 PECOS PAC ID: 6305110156 Enrollment ID: I20170919000008 |
| Provider Name | Denise Trent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659550846 PECOS PAC ID: 8426453424 Enrollment ID: I20210827002551 |
| Provider Name | Julius Lindo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427719103 PECOS PAC ID: 3274913066 Enrollment ID: I20220711003037 |
| Provider Name | Deanna Herbol |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043811623 PECOS PAC ID: 5395105621 Enrollment ID: I20230719000639 |
| Provider Name | Carlan Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710752027 PECOS PAC ID: 2668825589 Enrollment ID: I20240126003510 |
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