SOUTHSIDE COUNSELING CENTER, LLC (NPI# 1801968987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801968987 |
| Entity Type | Organization |
| Organization Name | SOUTHSIDE COUNSELING CENTER, LLC |
| Practice Address |
6072 Godwin Blvd Suffolk VA 23432-1012 |
| Mailing Address |
6072 Godwin Blvd Po Box 2387 Suffolk VA 23432-1012 |
| Practice Telephone | 7572552555 |
| Practice Fax Number | 7572557009 |
| Mailing Telephone | 7572552555 |
| Mailing Fax Number | 7572557009 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. SHARON W KRUMPE (OWNER) |
| Authorized Official Telephone | 7572552555 |
| Authorized Official Credential | LPC, LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YP2500X |
Counselor Specialization: Professional |
0701003187 | VA | Behavioral Health & Social Service Providers |
| X | 101YP2500X |
Counselor Specialization: Professional |
0701002307 | VA | Behavioral Health & Social Service Providers |
| X | 101YP2500X |
Counselor Specialization: Professional |
0701003999 | VA | Behavioral Health & Social Service Providers |
| X | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
0810001984 | VA | Behavioral Health & Social Service Providers |
| X | 106H00000X | Marriage & Family Therapist | 0717001033 | VA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356604235 | Southside Counseling Center, LLC | Community/Behavioral Health | 2015 Ayrsley Town Blvd Ste 202, Charlotte, NC 28273-4068 | 2012-06-17 |
| Street Address |
6072 GODWIN BLVD |
| City | SUFFOLK |
| State | VA |
| Zip Code | 23432-1012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679662571 | Sharon Wilson Krumpe | Counselor | 6072 Godwin Blvd, Pob 2387, Suffolk, VA 23432-1012 | 2006-10-11 |
| 1780074393 | Valerie Reed Fox | Counselor | 6072 Godwin Blvd, Southside Counseling Center, Suffolk, VA 23432-1012 | 2015-02-03 |
| 1386932606 | Jamie Hartsfield | Counselor | 6072 Godwin Blvd, Suffolk, VA 23432-1012 | 2011-07-20 |
| 1427129626 | Camilla S Schwoebel | Counselor | 6072 Godwin Blvd, Suffolk, VA 23432-1012 | 2006-11-11 |
| 1992876106 | Laurie M Craigen | Counselor | 6072 Godwin Blvd, Suffolk, VA 23432-1012 | 2006-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376082362 | Ashley Witt Rice | Nurse Practitioner | 100 Cherry Grove Rd N, Suffolk, VA 23432 | 2017-02-23 |
| 1366770547 | Philip R Thomas Md., Ltd | Legal Medicine | 112 Kings Hwy, Suffolk, VA 23432-1117 | 2009-11-25 |
| 1356594055 | Horses Healing Hearts, Pllc | Social Worker | 6100 Crittenden Rd, Suffolk, VA 23432-1204 | 2008-10-28 |
| 1154510600 | Wendy Lynn Fitch | Specialist | 1011 Cherry Grove Rd N, Suffolk, VA 23432-1811 | 2007-10-22 |
| 1962691410 | Stephanie Michelle Hadley | Specialist | 1011 Cherry Grove Rd N, Suffolk, VA 23432-1811 | 2007-10-22 |
| 1083238166 | Amanda Taylor Mccombs | Specialist/Technologist | 1853 Horseshoe Point Rd, Suffolk, VA 23432-1823 | 2020-06-03 |
| 1427380658 | Michael Kevin Edwards | Specialist/Technologist, Other | 1882 Mustang Trl, Suffolk, VA 23432-1832 | 2010-02-15 |
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942868575 | Bridget Seely | Counselor | 707 Gittings St Ste 120, Suffolk, VA 23434-6101 | 2019-05-29 |
| 1942864970 | Gabrielle B Gomoke | Counselor | 7025 Harbor View Blvd Ste 119, Suffolk, VA 23435-2762 | 2019-04-25 |
| 1629542352 | Chiquita Monique Merrill | Counselor | 7025 Harbour View Blvd, Suffolk, VA 23435-2761 | 2019-01-16 |
| 1073021234 | Keisha Arnold | Counselor | 3897 Bridge Rd, Suffolk, VA 23435-1911 | 2018-01-22 |
| 1548786692 | Suffolk Psychotherapy, Inc. | Counselor | 425 W Washington St Ste 4, Suffolk, VA 23434-5320 | 2017-08-21 |
| 1194136309 | Rebecca Jo Hodges | Counselor | 3327 Nansemond River Dr, Suffolk, VA 23435-1057 | 2014-05-12 |
| 1164727798 | Kenneth P Wells | Counselor | 1589 Steeple Dr, Suffolk, VA 23433-1615 | 2011-01-12 |
| 1770805178 | Nikkiah Wyatt Smith | Counselor | 5705 Lee Farm Ln Ste D, Suffolk, VA 23435 | 2010-02-25 |
| 1679662571 | Sharon Wilson Krumpe | Counselor | 6072 Godwin Blvd, Pob 2387, Suffolk, VA 23432-1012 | 2006-10-11 |
| 1679549729 | Therapeno Counseling and Congregational Wellness Svs, LLC | Counselor | 1028 Snead Dr, Suffolk, VA 23434 | 2006-02-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.