| George Ennels, Counseling And Consulting Services, Llc | |
|
2412 E Virginia Beach Blvd Ste D Norfolk VA 23504-3604 | |
| (757) 439-9026 | |
| (757) 622-8585 |
| Full Name | George Ennels, Counseling And Consulting Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2412 E Virginia Beach Blvd Ste D, Norfolk, Virginia |
| Authorized Official Name and Position | George Michael Ennels (SOCIAL WORKER) |
| Authorized Official Contact | 7574399026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| George Ennels, Counseling And Consulting Services, Llc 905 Merrimac Ave Norfolk VA 23504-4058 Ph: (757) 439-9026 | George Ennels, Counseling And Consulting Services, Llc 2412 E Virginia Beach Blvd Ste D Norfolk VA 23504-3604 Ph: (757) 439-9026 |
| NPI Number | 1497122105 |
|---|---|
| Provider Enumeration Date | 08/28/2015 |
| Last Update Date | 08/28/2015 |
| Medicare PECOS PAC ID | 6002123106 |
|---|---|
| Medicare Enrollment ID | O20150923000212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497122105 | NPI | - | NPPES |
| 1164595443 | Other | VA | INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0904000980 (Virginia) | Primary |
| Provider Name | George M Ennels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164595443 PECOS PAC ID: 2769507433 Enrollment ID: I20100917000785 |
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