| Panacea Behavioral Health & Wellness Center | |
|
4360 Shore Dr Ste 101 Virginia Beach VA 23455-2994 | |
| (757) 251-0879 | |
| (984) 220-9437 |
| Full Name | Panacea Behavioral Health & Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 4360 Shore Dr Ste 101, Virginia Beach, Virginia |
| Authorized Official Name and Position | Sandra Walker Nichols (CEO) |
| Authorized Official Contact | 7572510879 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Panacea Behavioral Health & Wellness Center 1700 Pleasure House Rd Ste 102a Virginia Beach VA 23455-4062 Ph: (757) 251-0879 | Panacea Behavioral Health & Wellness Center 4360 Shore Dr Ste 101 Virginia Beach VA 23455-2994 Ph: (757) 251-0879 |
| NPI Number | 1801489711 |
|---|---|
| Provider Enumeration Date | 02/11/2021 |
| Last Update Date | 10/16/2023 |
| Certification Date | 10/16/2023 |
| Medicare PECOS PAC ID | 7113329517 |
|---|---|
| Medicare Enrollment ID | O20210707003787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801489711 | NPI | - | NPPES |
| Provider Name | Michael S Prince |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295753630 PECOS PAC ID: 6800063421 Enrollment ID: I20120124000095 |
| Provider Name | Sandra Walker Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770749202 PECOS PAC ID: 0547304412 Enrollment ID: I20200330002712 |
| Provider Name | Christine Marie Brown |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316698004 PECOS PAC ID: 8921480625 Enrollment ID: I20220727003097 |
| Provider Name | Kenita D Murray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437769627 PECOS PAC ID: 0244615839 Enrollment ID: I20220919000598 |
| Provider Name | Krista Pembroke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043920606 PECOS PAC ID: 5799156121 Enrollment ID: I20230123002914 |
| Provider Name | Karen Higgins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619417532 PECOS PAC ID: 4183088115 Enrollment ID: I20230911000233 |
| Provider Name | Janet Enriquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043916265 PECOS PAC ID: 5294199733 Enrollment ID: I20230915002810 |
| Provider Name | Alice Baillio-hanchey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700669363 PECOS PAC ID: 7618322926 Enrollment ID: I20231005003619 |
| Provider Name | Suzanna Kathleen Doty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962285528 PECOS PAC ID: 0749639029 Enrollment ID: I20231212002024 |
| Provider Name | Sarah Louise Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104699552 PECOS PAC ID: 2466890074 Enrollment ID: I20240402001675 |
| Provider Name | Tyler Stott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912779497 PECOS PAC ID: 6709225360 Enrollment ID: I20240415003635 |
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