Provider Demographics
NPI:1417607599
Name:MASSEY, VIRGINIA (PROFESSIONAL COUNSEL)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:PROFESSIONAL COUNSEL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 S INDEPENDENCE BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1153
Mailing Address - Country:US
Mailing Address - Phone:757-520-0827
Mailing Address - Fax:
Practice Address - Street 1:472 POLARIS ST BLDG 586
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23461-1935
Practice Address - Country:US
Practice Address - Phone:757-862-0070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704013764101YM0800X, 101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health