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Organization
REDEFINE THERAPY, LLC
Active
Organization
REDEFINE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN L STACY LPC,CSAC (OWNER/THERAPIST)
(757) 632-0343
Entity
Organization
Contact information
Practice address
1216 GRANBY ST STE 211, NORFOLK, VA 23510-2622
(757) 632-0343
(757) 974-9374
Mailing address
1216 GRANBY ST STE 211, NORFOLK, VA 23510-2622
(757) 632-0343
(757) 974-9374
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306182795
—
VA
Enumeration date
02/06/2023
Last updated
07/01/2024
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