| Life's Journey | |
|
2551 Eltham Ave Ste F Norfolk VA 23513-2505 | |
| (757) 622-0700 | |
| (757) 622-2400 |
| Full Name | Life's Journey |
|---|---|
| Speciality | Clinic/Center |
| Location | 2551 Eltham Ave Ste F, Norfolk, Virginia |
| Authorized Official Name and Position | Shante Lenise Williams (COO) |
| Authorized Official Contact | 7576220700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life's Journey 2551 Eltham Ave Ste F Norfolk VA 23513-2505 Ph: (757) 622-0700 | Life's Journey 2551 Eltham Ave Ste F Norfolk VA 23513-2505 Ph: (757) 622-0700 |
| NPI Number | 1639533672 |
|---|---|
| Provider Enumeration Date | 04/06/2016 |
| Last Update Date | 11/24/2020 |
| Certification Date | 11/24/2020 |
| Medicare PECOS PAC ID | 8921410507 |
|---|---|
| Medicare Enrollment ID | O20201228000040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639533672 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Louisa A Ayafor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013165695 PECOS PAC ID: 8123283728 Enrollment ID: I20181016000685 |
| Provider Name | Nakkia N Grimes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194168278 PECOS PAC ID: 2163834748 Enrollment ID: I20201228000183 |
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