Organization
SEA CHANGE THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY C OVERMAN-GOLDSMITH MA LPC NCC (OWNER/CEO)
(252) 435-7747
Entity
Organization
Contact information
Practice address
3308 ASH VW, WILLIAMSBURG, VA 23185
(252) 435-7747
Mailing address
3308 ASH VW, WILLIAMSBURG, VA 23185-8101
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
NC
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
06/19/2017
Last updated
03/06/2019
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