| Suffolk Psychotherapy, Inc. | |
|
425 W Washington St Ste 4 Suffolk VA 23434-5320 | |
| (757) 809-5376 | |
| (757) 401-6912 |
| Full Name | Suffolk Psychotherapy, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 425 W Washington St Ste 4, Suffolk, Virginia |
| Authorized Official Name and Position | Shelina Parker (VICE PRESIDENT) |
| Authorized Official Contact | 7578095376 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suffolk Psychotherapy, Inc. 425 W Washington St Ste 4 Suffolk VA 23434-5320 Ph: (757) 809-5376 | Suffolk Psychotherapy, Inc. 425 W Washington St Ste 4 Suffolk VA 23434-5320 Ph: (757) 809-5376 |
| NPI Number | 1548786692 |
|---|---|
| Provider Enumeration Date | 08/21/2017 |
| Last Update Date | 05/06/2019 |
| Medicare PECOS PAC ID | 9234491192 |
|---|---|
| Medicare Enrollment ID | O20180313001628 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548786692 | NPI | - | NPPES |
| Provider Name | Venitta R Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124368691 PECOS PAC ID: 5496055519 Enrollment ID: I20151121000302 |
| Provider Name | Virginia A Stanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760999775 PECOS PAC ID: 2466716089 Enrollment ID: I20180508001410 |
| Provider Name | Noelle S Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649766569 PECOS PAC ID: 3678817913 Enrollment ID: I20181127003294 |
| Provider Name | Tanetta Hassell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962066258 PECOS PAC ID: 9133457617 Enrollment ID: I20190821003131 |
| Provider Name | Chiquita M Merrill |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629542352 PECOS PAC ID: 3678015278 Enrollment ID: I20240611002604 |
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