Organization
LITTLE CREEK COUNSELING CTR
Active
Organization
LITTLE CREEK COUNSELING CTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANCY TAYLOR MITCHUM PSYD LCP (PRESIDENT)
(757) 628-8337
Entity
Organization
Contact information
Practice address
1709 COLLEY AVE, STE 311, NORFOLK, VA 23517
(757) 628-8337
(757) 628-5911
Mailing address
1709 COLLEY AVE, STE 311, NORFOLK, VA 23517
(757) 628-8337
(757) 628-5911
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002730
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140543
ANTHEM BCBS
VA
Enumeration date
08/11/2006
Last updated
08/22/2020
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