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525 Dorothy Ct Chesapeake VA 23323 | |
| (757) 524-0461 | |
| (757) 800-8336 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 525 Dorothy Ct, Chesapeake, Virginia |
| Authorized Official Name and Position | Lynn Parker (OWNER) |
| Authorized Official Contact | 7575240461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1245g Cedar Rd # 223 Chesapeake VA 23322-7103 Ph: (757) 524-0461 | 525 Dorothy Ct Chesapeake VA 23323 Ph: (757) 524-0461 |
| NPI Number | 1952073355 |
|---|---|
| Provider Enumeration Date | 10/04/2021 |
| Last Update Date | 09/10/2024 |
| Certification Date | 09/10/2024 |
| Medicare PECOS PAC ID | 7315472446 |
|---|---|
| Medicare Enrollment ID | O20241126000506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952073355 | NPI | - | NPPES |
| 601019218 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Lynn Teresa Parker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548648256 PECOS PAC ID: 1052846193 Enrollment ID: I20241126001419 |
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