Individual
MS. DESTINY KATHERINE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
17579 WARWICK BLVD, NEWPORT NEWS, VA 23603-1343
(757) 888-0400
Mailing address
1436 N MOUNT VERNON AVE APT A, WILLIAMSBURG, VA 23185-7134
(540) 522-6881
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710103485
VA
101YM0800X
Mental Health Counselor
Primary
0701009025
VA
Other
Enumeration date
04/08/2020
Last updated
04/08/2020
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