Provider Demographics
| NPI: | 1245860105 |
|---|---|
| Name: | ASSOCIATES AT LYNNHAVEN COUNSELING |
| Entity type: | Organization |
| Organization Name: | ASSOCIATES AT LYNNHAVEN COUNSELING |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CREDENTIALING |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | KIM |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | RICHARDSON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 757-907-2567 |
| Mailing Address - Street 1: | 101 N LYNNHAVEN RD |
| Mailing Address - Street 2: | #302 |
| Mailing Address - City: | VIRGINIA BEACH |
| Mailing Address - State: | VA |
| Mailing Address - Zip Code: | 23452-7523 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 757-486-6955 |
| Mailing Address - Fax: | 757-486-3258 |
| Practice Address - Street 1: | 101 N LYNNHAVEN RD |
| Practice Address - Street 2: | #302 |
| Practice Address - City: | VIRGINIA BEACH |
| Practice Address - State: | VA |
| Practice Address - Zip Code: | 23452-7523 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 757-486-6955 |
| Practice Address - Fax: | 757-486-3258 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2020-01-20 |
| Last Update Date: | 2025-03-12 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |