Organization
ASSOCIATED COUNSELORS OF TIDEWATER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTIANNE HARMON (OFFICE MANAGER)
(757) 490-6960
Entity
Organization
Contact information
Practice address
287 INDEPENDENCE BLVD STE 219, VIRGINIA BEACH, VA 23462-2956
(757) 490-6960
(757) 490-6995
Mailing address
287 INDEPENDENCE BLVD STE 219, VIRGINIA BEACH, VA 23462-2956
(757) 490-6960
(757) 490-6995
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
07010001157
VA
101YP2500X
Professional Counselor
0701002379
VA
1041C0700X
Clinical Social Worker
0904002454
VA
106H00000X
Marriage & Family Therapist
0717000080
VA
106H00000X
Marriage & Family Therapist
0717000866
VA
Other
Enumeration date
07/19/2006
Last updated
07/23/2014
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