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Organization
TIDEWATER INSTITUTE OF NLP
Active
Organization
TIDEWATER INSTITUTE OF NLP
Active
Other names
Private Practice of Pamela Jo Kayanan
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA JO KAYANAN MED LPC LSATP LMFT (PRESIDENT)
(757) 643-8894
Entity
Organization
Contact information
Practice address
11747 JEFFERSON AVE, SUITE 6D, NEWPORT NEWS, VA 23606-1998
(757) 643-8894
(757) 643-8914
Mailing address
11747 JEFFERSON AVE, SUITE 6D, NEWPORT NEWS, VA 23606-1998
(757) 643-8894
(757) 643-8914
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0718000195
VA
101YP2500X
Professional Counselor
Primary
0701003183
VA
106H00000X
Marriage & Family Therapist
0717001073
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2577110
CAQH
VA
01
—
440869
ANTHEM BCBS
VA
Enumeration date
08/30/2006
Last updated
06/18/2008
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