Little Creek Counseling Ctr

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810002730 Issued in VA

Legal business name

LITTLE CREEK COUNSELING CTR

Practice address

1709 Colley Ave
Ste 311
Norfolk, VA 23517

Phone

(757) 628-8337

Fax

(757) 628-5911

NPI assigned

Aug 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Nancy Taylor Mitchum, PSYD LCPNPI 1356364566

Title

President

Phone

(757) 628-8337

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Nancy Taylor Mitchum, PSYD LCP

  • Clinical Psychologist
  • Norfolk, VA
  • NPI 1356364566
  NPD (past) Authorized official

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366453482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 COLLEY AVE",
            "address_2": "STE 311",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23517",
            "telephone_number": "757-628-8337",
            "fax_number": "757-628-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 COLLEY AVE",
            "address_2": "STE 311",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23517",
            "telephone_number": "757-628-8337",
            "fax_number": "757-628-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE CREEK COUNSELING CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHUM",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-628-8337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD LCP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "140543",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Zocco P C
• Meghan Lisenby, LCSW
• James C Lish, DDS
• Charles A Lisner, M.D.
• Francesca Klein Litow, MD
• Elena Bianca Little
• Tamara Little, CNM
• Lauren Litwak, OD
• Livassist LLC
• Live Body Brave

• Clinical Psychologist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.