Organization
AGAPE COUNSELING & THERAPEUTIC SERVICES, INC
Active
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
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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