NPIMap

Organization Active NPI

Seaside Behavioral Health

  • Counselor
  • Virginia Beach, VA
National Provider Identifier
1295284255
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
SEASIDE BEHAVIORAL HEALTH
Practice address
1072 Laskin Rd Ste 104
Virginia Beach, VA 23451-6387
Phone
(757) 648-8605
Fax
(757) 648-1363
NPI assigned
Sep 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carolyn A Baxter, CPC
Title
Practice Administrator
Phone
(757) 648-8605

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

1072 Laskin Rd Ste 104
Virginia Beach, VA 23451-6387

Mailing address

1072 Laskin Rd Ste 104
Virginia Beach, VA 23451-6387
Phone (757) 648-8605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170127000049 VA Part B Supplier - Clinic/Group Practice 6709168776 Receives reassigned benefits from 7 practitioners
Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory

Locations

1072 Laskin Rd
Ste 104
Virginia Beach, VA 23451
Phone (757) 648-8605

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1295284255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 LASKIN RD STE 104",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516387",
            "telephone_number": "757-648-8605",
            "fax_number": "757-648-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 LASKIN RD STE 104",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516387",
            "telephone_number": "757-648-8605",
            "fax_number": "757-648-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "757-648-8605",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.