| Focused Growth Psychotherapy | |
|
2509 Butler Lane #133 Virginia Beach VA 23456-4419 | |
| (757) 702-0119 | |
| (757) 702-0119 |
| Full Name | Focused Growth Psychotherapy |
|---|---|
| Speciality | Counselor |
| Location | 2509 Butler Lane, Virginia Beach, Virginia |
| Authorized Official Name and Position | Sharon Wickham (LCSW, MBR) |
| Authorized Official Contact | 7577020119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Focused Growth Psychotherapy 3419 Virginia Beach Blvd #133 Virginia Beach VA 23452-4419 Ph: (757) 702-0119 | Focused Growth Psychotherapy 2509 Butler Lane #133 Virginia Beach VA 23456-4419 Ph: (757) 702-0119 |
| NPI Number | 1306509252 |
|---|---|
| Provider Enumeration Date | 10/18/2021 |
| Last Update Date | 10/18/2021 |
| Certification Date | 10/18/2021 |
| Medicare PECOS PAC ID | 6507256211 |
|---|---|
| Medicare Enrollment ID | O20211210001289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306509252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Sharon J Wickham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194800771 PECOS PAC ID: 2860394699 Enrollment ID: I20040122000943 |
| Provider Name | Susan A Dempsey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578648168 PECOS PAC ID: 1557432390 Enrollment ID: I20150420000514 |
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