| Endurance Cousneling And Supervision Services,llc | |
|
324 Lynnhaven Dr Hampton VA 23666-2300 | |
| (757) 964-9543 | |
| (757) 964-9567 |
| Full Name | Endurance Cousneling And Supervision Services,llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 324 Lynnhaven Dr, Hampton, Virginia |
| Authorized Official Name and Position | Jamicia L Davis (CEO AND THERAPIST) |
| Authorized Official Contact | 7579649543 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Endurance Cousneling And Supervision Services,llc 1706 Todds Ln # 275 Hampton VA 23666-3123 Ph: (757) 964-9543 | Endurance Cousneling And Supervision Services,llc 324 Lynnhaven Dr Hampton VA 23666-2300 Ph: (757) 964-9543 |
| NPI Number | 1225637218 |
|---|---|
| Provider Enumeration Date | 10/20/2020 |
| Last Update Date | 10/20/2020 |
| Certification Date | 10/20/2020 |
| Medicare PECOS PAC ID | 0648652362 |
|---|---|
| Medicare Enrollment ID | O20220727003603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225637218 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jamicia Lanece Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528537271 PECOS PAC ID: 4082954862 Enrollment ID: I20190313001858 |
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