| Tidewater Pastoral Counseling Services, Inc | |
|
7305 Hampton Blvd Norfolk VA 23505-2923 | |
| (757) 623-2700 | |
| (757) 640-1058 |
| Full Name | Tidewater Pastoral Counseling Services, Inc |
|---|---|
| Speciality | Counselor |
| Location | 7305 Hampton Blvd, Norfolk, Virginia |
| Authorized Official Name and Position | Martin W Phillips (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7576232700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidewater Pastoral Counseling Services, Inc 7305 Hampton Blvd Norfolk VA 23505-2923 Ph: (757) 623-2700 | Tidewater Pastoral Counseling Services, Inc 7305 Hampton Blvd Norfolk VA 23505-2923 Ph: (757) 623-2700 |
| NPI Number | 1407014509 |
|---|---|
| Provider Enumeration Date | 05/27/2008 |
| Last Update Date | 02/29/2012 |
| Medicare PECOS PAC ID | 3072772268 |
|---|---|
| Medicare Enrollment ID | O20120307000544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407014509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP1600X | Counselor - Pastoral | 0701000401 (Virginia) | Primary |
| Provider Name | Brenda L Gilmore-hicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043373186 PECOS PAC ID: 1557491925 Enrollment ID: I20100610000832 |
| Provider Name | Peggy W Newman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285718080 PECOS PAC ID: 0941469134 Enrollment ID: I20120307000578 |
| Provider Name | Linda Delores Townes Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588896716 PECOS PAC ID: 3678795044 Enrollment ID: I20141119002045 |
| Provider Name | Patricia Jane Hoeft |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1023179074 PECOS PAC ID: 2668410135 Enrollment ID: I20240124000612 |
| Provider Name | Sarah R. Massie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669611182 PECOS PAC ID: 1759724586 Enrollment ID: I20240208003692 |
| Provider Name | Martin Wynn Phillips |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720179146 PECOS PAC ID: 7517126709 Enrollment ID: I20240219002032 |
| Provider Name | William Marcus Small |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386411650 PECOS PAC ID: 2365888930 Enrollment ID: I20240306002489 |
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