Individual
MR. KENNETH WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4445 COPORATION LANE, SUITE 200, VIRGINIA BEACH, VA 23462
(757) 213-6800
(757) 240-5936
Mailing address
4445 CORPORATION LN STE 200, VIRGINIA BEACH, VA 23462-3262
(757) 213-6800
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701003278
VA
101YP2500X
Professional Counselor
0701003278
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005413281
—
VA
01
—
089635
SENTARA OPTIMA
—
01
—
201351
COMPSYCH
—
01
—
2123895
MAMSI
—
01
—
2193340
CIGNA
—
01
—
327272
MANAGED HEALTH NETWORK
—
01
—
385289
BCBS
—
01
—
488552
MAGELLAN
—
Enumeration date
02/08/2006
Last updated
10/03/2025
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