| The Healing Fountain, Llc | |
|
762 Independence Blvd Suite 100c Virginia Beach VA 23455-6200 | |
| (757) 486-1807 | |
| (757) 486-0901 |
| Full Name | The Healing Fountain, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 762 Independence Blvd, Virginia Beach, Virginia |
| Authorized Official Name and Position | Pamela J Hopkins (PRESIDENT) |
| Authorized Official Contact | 7574861807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Healing Fountain, Llc 762 Independence Blvd Suite 100c Virginia Beach VA 23455-6200 Ph: (757) 486-1807 | The Healing Fountain, Llc 762 Independence Blvd Suite 100c Virginia Beach VA 23455-6200 Ph: (757) 486-1807 |
| NPI Number | 1609807304 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 09/14/2009 |
| Medicare PECOS PAC ID | 6608960406 |
|---|---|
| Medicare Enrollment ID | O20070925000197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609807304 | NPI | - | NPPES |
| 087506M | Other | VA | OPTIMA |
| 008931909 | Medicaid | VA | |
| 89750 | Other | VA | BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904003726 (Virginia) | Primary |
| Provider Name | Pamela J Hopkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568491777 PECOS PAC ID: 2062506868 Enrollment ID: I20070926000999 |
| Provider Name | Jennifer Hart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326674045 PECOS PAC ID: 8628490778 Enrollment ID: I20200619000411 |
| Provider Name | Melissa Hill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194160747 PECOS PAC ID: 5991117954 Enrollment ID: I20201215003048 |
| Provider Name | Laura A Stanzione |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558505040 PECOS PAC ID: 5799172862 Enrollment ID: I20220420002446 |
| Provider Name | Barbara E Barrett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831596766 PECOS PAC ID: 5799137923 Enrollment ID: I20240123003584 |
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