| Sanctyouary | |
|
900 Commonwealth Pl Ste 2001020 Virginia Beach VA 23464-4517 | |
| (757) 749-8507 | |
| Not Available |
| Full Name | Sanctyouary |
|---|---|
| Speciality | Social Worker |
| Location | 900 Commonwealth Pl Ste 2001020, Virginia Beach, Virginia |
| Authorized Official Name and Position | Keimishia Holloway (REGISTERD NURSE) |
| Authorized Official Contact | 7577498507 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanctyouary 900 Commonwealth Pl Ste 2001020 Virginia Beach VA 23464-4517 Ph: (757) 749-8507 | Sanctyouary 900 Commonwealth Pl Ste 2001020 Virginia Beach VA 23464-4517 Ph: (757) 749-8507 |
| NPI Number | 1588440119 |
|---|---|
| Provider Enumeration Date | 09/08/2023 |
| Last Update Date | 10/30/2023 |
| Certification Date | 10/30/2023 |
| Medicare PECOS PAC ID | 8022550011 |
|---|---|
| Medicare Enrollment ID | O20240605003030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588440119 | NPI | - | NPPES |
| Provider Name | Yasmeen Atyia Ayesha Burnell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205543410 PECOS PAC ID: 4082085089 Enrollment ID: I20230131001602 |
| Provider Name | Nkese Williams-hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013625177 PECOS PAC ID: 6305207853 Enrollment ID: I20230731002046 |
| Provider Name | Erin K Idehenre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851813661 PECOS PAC ID: 5698214971 Enrollment ID: I20240830000782 |
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