| D'vine Intervention Counseling Center | |
|
2424 Oak Street Portsmouth VA 27870 | |
| (252) 673-3196 | |
| Not Available |
| Full Name | D'vine Intervention Counseling Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2424 Oak Street, Portsmouth, Virginia |
| Authorized Official Name and Position | Letesha Renee' Gibson (CHRISTIAN THERAPIST/OWNER) |
| Authorized Official Contact | 2526733196 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| D'vine Intervention Counseling Center 116 Piedmont Court Roanoke Rapids NC 27870 Ph: (252) 673-3196 | D'vine Intervention Counseling Center 2424 Oak Street Portsmouth VA 27870 Ph: (252) 673-3196 |
| NPI Number | 1215323274 |
|---|---|
| Provider Enumeration Date | 04/07/2015 |
| Last Update Date | 04/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215323274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0701005691 (Virginia) | Primary |
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