Basic Information
| Provider Information | |||||||||
| NPI: | 1699303677 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PURSUIT COUNSELING | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2501 ALLEGHANY LOOP | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234562442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8583490873 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2501 ALLEGHANY LOOP | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234562442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8583490873 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2020 | ||||||||
| LastUpdateDate: | 03/27/2020 | ||||||||
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| AuthorizedOfficialLastName: | HOLSTON | ||||||||
| AuthorizedOfficialFirstName: | JESSECA | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 8583490873 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LMFT | ||||||||
| NPICertificationDate: | 03/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.