Safe Harbor Christian Counseling of Hampton Roads LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810004338 Issued in VA

Legal business name

SAFE HARBOR CHRISTIAN COUNSELING OF HAMPTON ROADS LLC

Practice address

728 Oxford Dr
Virginia Beach, VA 23452-5843

Phone

(757) 354-0620

Fax

(410) 569-0094

NPI assigned

Jan 6, 2012

Organization subpart

Yes

Parent organization

SAFE HARBOR CHRISTIAN COUNSELING LLCAs reported in NPPES

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

Authorized official

Name

Jennifer Moskos

Title

Credentialing Coordinator

Phone

(410) 569-9497

Specialties & licenses 1

Addresses

Part of

Safe Harbor Christian CNSL

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325808000000",
    "number": "1407126485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 OXFORD DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234525843",
            "telephone_number": "757-354-0620",
            "fax_number": "410-569-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 OXFORD DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234525843",
            "telephone_number": "757-354-0620",
            "fax_number": "410-569-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HARBOR CHRISTIAN COUNSELING OF HAMPTON ROADS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAFE HARBOR CHRISTIAN COUNSELING LLC",
        "enumeration_date": "2012-01-06",
        "last_updated": "2012-01-06",
        "status": "A",
        "authorized_official_last_name": "MOSKOS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "410-569-9497"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2012; 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.