Organization
CHESAPEAKE COMMUNITY SERVICES BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA THIVIERGE (REIMBURSEMENT SUPERVISOR)
(757) 819-6219
Entity
Organization
Contact information
Practice address
224 GREAT BRIDGE BLVD, CHESAPEAKE, VA 23320-3904
(757) 547-9334
Mailing address
224 GREAT BRIDGE BLVD, CHESAPEAKE, VA 23320-3904
(757) 547-9334
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004407
VA
106H00000X
Marriage & Family Therapist
0717001184
VA
Other
Enumeration date
01/16/2009
Last updated
01/16/2009
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