PEMBROKE PSYCHOTHERAPY LLC (NPI# 1871119321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871119321 |
| Entity Type | Organization |
| Organization Name | PEMBROKE PSYCHOTHERAPY LLC |
| Practice Address |
4605 Pembroke Lake Cir Ste 103c Virginia Beach VA 23455-6434 |
| Practice Telephone | 5026933760 |
| Practice Fax Number | 7579040830 |
| Mailing Telephone | 5026933760 |
| Mailing Fax Number | 7579040830 |
| Enumeration Date | 2020-06-21 |
| Last Update Date | 2020-06-21 |
| Authorized Official Name | MS. JAN E EDWARDS (PSYCHOTHERAPIST, OWNER) |
| Authorized Official Telephone | 5026933760 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
4605 PEMBROKE LAKE CIR STE 103C |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23455-6434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093324162 | Evoscient Gynecology Center for Pelvic Health and Surgery, PC | Obstetrics & Gynecology | 108 Independence Blvd, Suite 162, Virginia Beach, VA 23455 | 2020-07-24 |
| 1942728571 | Delois L Dillard | Occupational Therapy Assistant | 4225 Shore Drive, Virginia Beach, VA 23455 | 2017-09-04 |
| 1295255404 | Unobs Medical Transportation Services LLC | Non-emergency Medical Transport (VAN) | 5812 Tajo Avenue, Virginia Beach, VA 23455 | 2017-06-20 |
| 1831640812 | Wearefit | Dietitian, Registered | 4752 Hollis Road, Virginia Beach, VA 23455 | 2016-10-14 |
| 1629496633 | Jamie Lauren Dermatis | Podiatrist | 1700 Pleasure Road, #101, Virginia Beach, VA 23455 | 2014-04-07 |
| 1619304664 | Syed A Absar | Pharmacist | 4828 Lake Bradford Lane, Virginia Beach, VA 23455 | 2013-10-07 |
| 1851734958 | Cara K Richardson | Occupational Therapist | 2364 Madison Ave., Virginia Beach, VA 23455 | 2013-04-09 |
| 1811249287 | Chl & Associates | Nurse Practitioner | 1367 Sir Richard Rd, Virginia Beach, VA 23455 | 2012-10-10 |
| 1588915425 | Edward S Wilson | Physician Assistant | 604 Bishop Dr, Virginia Beach, VA 23455 | 2012-10-01 |
| 1073886842 | April Gilbrech | Registered Nurse | 1103 Canopy Ct, Virginia Beach, VA 23455 | 2012-02-09 |
| Find all providers in zip 23455 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356941181 | Amy H Drescher LLC | Counselor | 3615 Atlantic Ave Apt 302, Virginia Beach, VA 23451-2749 | 2020-10-30 |
| 1629678735 | Stephanie Ellzey | Counselor | 4169 Virginia Beach Blvd Ste 150, Virginia Beach, VA 23452-1783 | 2020-10-28 |
| 1881208650 | Tracie Marie Romero | Counselor | 236 Mustag Trail Ste, Virginia Beach, VA 23452 | 2020-08-31 |
| 1912510991 | Briahna Van Nostern | Counselor | 669 Pinebrook Dr, Virginia Beach, VA 23462-4772 | 2020-08-28 |
| 1750999280 | Barbara Stuart Ford | Counselor | 6477 College Park Sq Ste 216, Virginia Beach, VA 23464-3611 | 2020-07-21 |
| 1184242489 | Leah Laura Crawford | Counselor | 2397 Liberty Way Ste 103, Virginia Beach, VA 23456-3464 | 2020-07-13 |
| 1285256768 | Robyn Melinda Leroy | Counselor | 1064 Laskin Rd Ste 14c, Virginia Beach, VA 23451-6337 | 2020-05-07 |
| 1013543560 | Frank Douglass Bond | Counselor | 5267 Greenwich Rd Ste 100, Virginia Beach, VA 23462-6028 | 2020-03-17 |
| 1821621640 | Hailey Rae Gier | Counselor | 4420 Bear Trl, Virginia Beach, VA 23456-7308 | 2020-02-20 |
| 1821621038 | Rapha Counseling Services | Counselor | 1244 Thompkins Ln, Virginia Beach, VA 23464-5228 | 2020-02-16 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23455 |
Please comment or provide details below to improve the information on PEMBROKE PSYCHOTHERAPY LLC.
| 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.