Provider Demographics
NPI:1124676564
Name:FEELING MOODY LLC
Entity type:Organization
Organization Name:FEELING MOODY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:DYVERYNCE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-955-4073
Mailing Address - Street 1:2461 OLD GREENBRIER RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-4935
Mailing Address - Country:US
Mailing Address - Phone:757-560-3160
Mailing Address - Fax:
Practice Address - Street 1:816 INDEPENDENCE BLVD STE 1A
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6010
Practice Address - Country:US
Practice Address - Phone:757-955-4073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)