Provider Demographics
NPI:1457639221
Name:GLOVER, CRISTA (PHD)
Entity type:Individual
Prefix:DR
First Name:CRISTA
Middle Name:
Last Name:GLOVER
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 REGENT UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-5037
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2528 LAS BRISAS DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-4264
Practice Address - Country:US
Practice Address - Phone:757-683-4401
Practice Address - Fax:757-683-3565
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA# 0701005513101YP2500X
OHE.1100042101YP2500X
NC8419101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional