Family Wellness and Recovery Center, LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

95221

Legal business name

FAMILY WELLNESS AND RECOVERY CENTER, LLC

Practice address

5121 E. Virginia Beach Blvd, Suite C-2
Norfolk, VA 23502-4041

Phone

(757) 962-9644

Fax

(757) 383-6135

NPI assigned

Feb 1, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Gloria Robin Polite, LPC

Title

Executive Director

Phone

(757) 962-9644

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485907200000",
    "number": "1922546746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 E. VIRGINIA BEACH BLVD, SUITE C-2",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024041",
            "telephone_number": "757-962-9644",
            "fax_number": "757-383-6135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 E. VIRGINIA BEACH BLVD, SUITE C-2",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024041",
            "telephone_number": "757-962-9644",
            "fax_number": "757-383-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY WELLNESS AND RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-02-01",
        "status": "A",
        "authorized_official_last_name": "POLITE",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "ROBIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "757-962-9644",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": "95221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Norfolk, VA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.