Diva,LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

DIVA,LLC

Practice address

1024 Center Brooke Lane
F427
Suffolk, VA 23434

Phone

(540) 446-9877

Fax

(866) 743-5703

NPI assigned

Nov 1, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Patricia Clark, LPC

Title

Owner

Phone

(540) 446-9877

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1992528715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 CENTER BROOKE LANE",
            "address_2": "F427",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23434",
            "telephone_number": "540-446-9877",
            "fax_number": "866-743-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 CENTER BROOKE LANE",
            "address_2": "F427",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23434",
            "telephone_number": "540-446-9877",
            "fax_number": "866-743-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVA,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-01",
        "last_updated": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-446-9877",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.