Organization
SELF ACTUALIZATION COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RONEIKO HENDERSON-BEASLEY LCSW (OWNER/DIRECTOR)
(757) 287-4990
Entity
Organization
Contact information
Practice address
3500 VIRGINIA BEACH BLVD, SUITE 210, VIRGINIA BEACH, VA 23452-4445
(757) 233-1900
Mailing address
3500 VIRGINIA BEACH BLVD, SUITE 210, VIRGINIA BEACH, VA 23452-4445
(757) 233-1900
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
0904008490
VA
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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