Organization
MASTERSON PSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MASTERSON LCSW (OWNER)
(757) 237-2906
Entity
Organization
Contact information
Practice address
4445 CORPORATION LN STE 213, VIRGINIA BEACH, VA 23462-3262
(757) 237-2906
(757) 216-9655
Mailing address
4445 CORPORATION LN STE 213, VIRGINIA BEACH, VA 23462-3262
(757) 237-2906
(757) 216-9655
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
0904006823
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851552491
—
VA
Enumeration date
08/21/2018
Last updated
04/23/2024
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