| Little Creek Counseling Ctr | |
|
1709 Colley Ave Ste 311 Norfolk VA 23517 | |
| (757) 628-8337 | |
| (757) 628-5911 |
| Full Name | Little Creek Counseling Ctr |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1709 Colley Ave, Norfolk, Virginia |
| Authorized Official Name and Position | Nancy Taylor Mitchum (PRESIDENT) |
| Authorized Official Contact | 7576288337 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Little Creek Counseling Ctr 1709 Colley Ave Ste 311 Norfolk VA 23517 Ph: (757) 628-8337 | Little Creek Counseling Ctr 1709 Colley Ave Ste 311 Norfolk VA 23517 Ph: (757) 628-8337 |
| NPI Number | 1366453482 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366453482 | NPI | - | NPPES |
| 140543 | Other | VA | ANTHEM BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0810002730 (Virginia) | Primary |
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