Provider Demographics
NPI:1194550764
Name:MLP2 LLC
Entity type:Organization
Organization Name:MLP2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-288-7350
Mailing Address - Street 1:305 BROOKE AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1346
Mailing Address - Country:US
Mailing Address - Phone:757-288-7350
Mailing Address - Fax:
Practice Address - Street 1:4164 VIRGINIA BEACH BLVD STE 202
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1762
Practice Address - Country:US
Practice Address - Phone:757-306-4232
Practice Address - Fax:757-306-4235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health