Obsidian Counseling and Wellness Center, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

OBSIDIAN COUNSELING AND WELLNESS CENTER, LLC

Practice address

6387 Center Dr Ste 19
Norfolk, VA 23502-4109

Phone

(757) 453-3051

NPI assigned

Oct 25, 2019

Organization subpart

No

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

Authorized official

Name

Natasha Beckum, LPCNPI 1922451186

Title

Chief Executive Officer/LPC

Phone

(757) 453-3051

Specialties & licenses 1

Addresses

Other names 1

• Obsidian Counseling and Wellness Center Doing business as

Locations

Practitioners 1

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

• Natasha M Beckum, LPC

  • Mental Health Counselor
  • Chesapeake, VA
  • NPI 1922451186
  NPD Authorized official

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1508409152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "857 GEORGE WASHINGTON HWY N UNIT 6991",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233231362",
            "telephone_number": "757-453-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6387 CENTER DR STE 19",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024109",
            "telephone_number": "757-453-3051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6330 Newtown Rd Ste 525",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235024807",
            "country_code": "US",
            "telephone_number": "757-453-3051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OBSIDIAN COUNSELING AND WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-25",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A",
        "authorized_official_last_name": "BECKUM",
        "authorized_official_first_name": "NATASHA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER/LPC",
        "authorized_official_telephone_number": "757-453-3051",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Obsidian Counseling and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Obsidian Counseling and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.