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Organization

AGAPE COUNSELING & THERAPEUTIC SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TEISHA SPARROW (CREDENTIALING SPEC)
(757) 244-3500
Entity
Organization

Contact information

Practice address
3221 COMMANDER SHEPARD BLVD, HAMPTON, VA 23666-1598
(757) 244-3500
(877) 468-5361
Mailing address
3221 COMMANDER SHEPARD BLVD, HAMPTON, VA 23666-1598
(757) 244-3500
(877) 468-5361

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
0904004904
VA
101YP2500X
Professional Counselor
103TC0700X
Clinical Psychologist
103TH0004X
Health Psychologist
104100000X
Social Worker
1041C0700X
Clinical Social Worker
0904002584
VA
1041C0700X
Clinical Social Worker
0904004904
VA
1041C0700X
Clinical Social Worker
172V00000X
Community Health Worker
251S00000X
Community/Behavioral Health Agency
0904004904
VA
251S00000X
Community/Behavioral Health Agency
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11526769
CAQH
VA
01
13953971
CAQH
VA
05
8936358
VA
01
Q42793C284
MEDICAARE PTAN
VA
01
Q46363C284
MEDICARE PTAN
VA
01
Q59697C284
MEDICARE PTAN
VA
Enumeration date
07/19/2006
Last updated
02/08/2021
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