Restorer Of Broken Walls in Chesapeake - Counselor
Restorer Of Broken Walls - NPI 1811080047
Restorer Of Broken Walls is a Counselor in Chesapeake, Virginia. Restorer Of Broken Walls practices all healthcare services and medical treatments related to Counselor. The NPI Number for Restorer Of Broken Walls is 1811080047. The last update date is 2020-08-22.
Restorer Of Broken Walls's current location address is 644 Independence Parkway, Chesapeake, Virginia. You can contact this provider via phone number 7575471811 and fax number 7575471118. The mailing address for Restorer Of Broken Walls is 644 Independence Parkway, Chesapeake, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Restorer Of Broken Walls |
|---|---|
| Address | 644 Independence Parkway, Chesapeake, Virginia |
| Phone Number | 7575471811 |
| Fax Number | 7575471118 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PROGRAM DI |
|---|---|
| Authorized Official Name | Grizzard Bowers Amanda |
| Credentials | LPC LMFT |
| Telephone Number | 7575471811 |
NPI Number Detail
| NPI Number | 1811080047 |
|---|---|
| Provider Enumeration Date | 2006-10-02 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 644 Independence Parkway |
|---|---|
| City | Chesapeake |
| State | Virginia (VA) |
| Post Code | 23320 |
| Phone Number | 7575471811 |
| Fax Number | 7575471118 |
Provider's Primary Taxonomy Detail
| Speciality | Counselor |
|---|---|
| Taxonomy | 101Y00000X |
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Definition: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supe |
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What is the unique identification code assigned to Restorer Of Broken Walls by the Centers for Medicare & Medicaid Services?
The Restorer Of Broken Walls has been issued the NPI (National Provider Identifier) 1811080047. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Restorer Of Broken Walls is physically located?
The Restorer Of Broken Walls is situated at the following address: 644 Independence Parkway, Chesapeake, VA 23320.
What is the Restorer Of Broken Walls's area of specialization and corresponding taxonomy classification?
The Restorer Of Broken Walls's specialty field is Counselor, and it falls under the taxonomy code 101Y00000X, which categorizes healthcare providers based on their specialties.
When did the Restorer Of Broken Walls receive its 1811080047?
The Restorer Of Broken Walls was issued its 1811080047 on 2006-10-02, which is the date when the organization was assigned this unique identifier.
As of what date was the information regarding Restorer Of Broken Walls, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Restorer Of Broken Walls, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2020-08-22.
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