Organization
SAMPAGUITA PSYCHOTHERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MACARAEG LCSW (OWNER)
(757) 681-5606
Entity
Organization
Contact information
Practice address
2712 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23452-7615
(757) 681-5606
Mailing address
2712 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23452-7615
(757) 681-5606
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904014643
LCSW
VA
Enumeration date
09/04/2023
Last updated
03/17/2024
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