The Children and Adult Counseling Center LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

THE CHILDREN AND ADULT COUNSELING CENTER LLC

Practice address

930 Majestic Ave Ste 100
Norfolk, VA 23504-4055

Phone

(757) 627-1099

Fax

(757) 640-0954

NPI assigned

Jun 8, 2020

Organization subpart

No

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

Authorized official

Name

Paul Walker Jr., PH.D.NPI 1235470733

Title

Owner/Provider Authorized Official

Phone

(757) 627-1099

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 1

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

• Paul Walker Jr., PHD

  • Clinical Psychologist
  • Virginia Beach, VA
  • NPI 1235470733
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1841814639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 MAJESTIC AVE STE 100",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235044055",
            "telephone_number": "757-627-1099",
            "fax_number": "757-640-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MAJESTIC AVE STE 100",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235044055",
            "telephone_number": "757-627-1099",
            "fax_number": "757-640-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHILDREN AND ADULT COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER/PROVIDER AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "757-627-1099",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 25, 2020; 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.