| Summit Counseling Services | |
|
821 W 21st St Ste 209 Norfolk VA 23517-1500 | |
| (757) 280-1777 | |
| (757) 585-3521 |
| Full Name | Summit Counseling Services |
|---|---|
| Speciality | Counselor |
| Location | 821 W 21st St Ste 209, Norfolk, Virginia |
| Authorized Official Name and Position | Laura S. Maloney (OWNER/CLINICIAN) |
| Authorized Official Contact | 7574721379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Counseling Services 208 Burleigh Ave Norfolk VA 23505-3413 Ph: (757) 472-1379 | Summit Counseling Services 821 W 21st St Ste 209 Norfolk VA 23517-1500 Ph: (757) 280-1777 |
| NPI Number | 1316404544 |
|---|---|
| Provider Enumeration Date | 02/24/2019 |
| Last Update Date | 09/07/2023 |
| Certification Date | 09/07/2023 |
| Medicare PECOS PAC ID | 2961833116 |
|---|---|
| Medicare Enrollment ID | O20200504001567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316404544 | NPI | - | NPPES |
| 010001625 | Medicaid | VA | |
| 0701003466 | Other | VA | LPC |
| 0717001169 | Other | VA | LMFT |
| Provider Name | Stephanie Theresa Gagnon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063530145 PECOS PAC ID: 0446688170 Enrollment ID: I20200312000158 |
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