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1702 Todds Ln Ste 385 Hampton VA 23666-3212 | |
| (757) 768-6288 | |
| (757) 800-0188 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 1702 Todds Ln Ste 385, Hampton, Virginia |
| Authorized Official Name and Position | Vonetta C Thompson (OWNER) |
| Authorized Official Contact | 9156664904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
112 Settlers Landing Rd Suffolk VA 23435-1740 Ph: (757) 768-6148 | 1702 Todds Ln Ste 385 Hampton VA 23666-3212 Ph: (757) 768-6288 |
| NPI Number | 1538907126 |
|---|---|
| Provider Enumeration Date | 07/17/2024 |
| Last Update Date | 08/28/2024 |
| Certification Date | 08/28/2024 |
| Medicare PECOS PAC ID | 8325572209 |
|---|---|
| Medicare Enrollment ID | O20241114002916 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538907126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Vonetta Coleman Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598949067 PECOS PAC ID: 4587930029 Enrollment ID: I20171027000537 |
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