City Of Virginia Beach | |
3143 Magic Hollow Blvd Ste 200 Virginia Beach VA 23453-3077 | |
(757) 385-0687 | |
(757) 306-5801 |
Full Name | City Of Virginia Beach |
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Speciality | Clinic/Center |
Location | 3143 Magic Hollow Blvd Ste 200, Virginia Beach, Virginia |
Authorized Official Name and Position | Margaret G Bailey (REIMBURSEMENT) |
Authorized Official Contact | 7573850687 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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City Of Virginia Beach 3432 Virginia Beach Blvd Virginia Beach VA 23452-4420 Ph: (757) 385-0684 | City Of Virginia Beach 3143 Magic Hollow Blvd Ste 200 Virginia Beach VA 23453-3077 Ph: (757) 385-0687 |
NPI Number | 1861562472 |
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Provider Enumeration Date | 11/09/2006 |
Last Update Date | 04/18/2022 |
Certification Date | 04/18/2022 |
Medicare PECOS PAC ID | 7810880911 |
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Medicare Enrollment ID | O20040203000933 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861562472 | NPI | - | NPPES |
1861562472 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 261 (Virginia) | Primary |
Provider Name | Frank A Roberto |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1669467254 PECOS PAC ID: 6406810233 Enrollment ID: I20041112000163 |
Provider Name | Cheryl M Segal |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003036690 PECOS PAC ID: 8729037098 Enrollment ID: I20050113001030 |
Provider Name | Maria Regina G Cenzon |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1104995778 PECOS PAC ID: 0941232094 Enrollment ID: I20050909000138 |
Provider Name | Matthew Faauli |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1518101385 PECOS PAC ID: 6305978800 Enrollment ID: I20100720000078 |
Provider Name | Louis M Leone |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1558522631 PECOS PAC ID: 2860664026 Enrollment ID: I20111012000082 |
Provider Name | Edith Kathleen Jones |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356993448 PECOS PAC ID: 0941632996 Enrollment ID: I20191113003130 |
Provider Name | Angela Romano |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1487810537 PECOS PAC ID: 9638406630 Enrollment ID: I20240318001956 |
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