Provider Demographics
NPI:1699321927
Name:LEVEL GROUND PSYCHOTHERAPY SERVICES LLC
Entity type:Organization
Organization Name:LEVEL GROUND PSYCHOTHERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:MURCHISON-GRICE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-522-7011
Mailing Address - Street 1:14203 OLD COURTHOUSE WAY STE C
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-3749
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14203 OLD COURTHOUSE WAY STE C
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-3749
Practice Address - Country:US
Practice Address - Phone:757-522-7011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701008249OtherOWNER'S LICENSE NUMBER