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HOUSE OF REFUGE RESTORATION LLC NPI 1124255260


NPI Information

NPI: 1124255260
Provider Name: HOUSE OF REFUGE RESTORATION, LLC

Other Name: HOUSE OF REFUGE

Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
805 SHADOWBERRY CRST
CHESAPEAKE, VA
ZIP 23320
Phone: (757) 560-1944
Get Directions

HOUSE OF REFUGE RESTORATION, LLC is a clinical social worker in Chesapeake, VA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. HOUSE OF REFUGE RESTORATION, LLC NPI is 1124255260. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is House Of Refuge.

The provider's business location address is:

805 SHADOWBERRY CRST
CHESAPEAKE, VA
ZIP 23320-544
Phone: (757) 560-1944
Fax: (877) 468-5361

The provider's authorized official is Teisha Etheridge .
The authorized official title is Program Director and has the following contact phone number (757) 560-1944.

The enumeration date for this NPI number is 6/16/2009 and was last updated on 6/16/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselor0812000532VIRGINIANo
2101Y00000XCounselor0710102115VIRGINIANo
3101YA0400XCounselorAddiction (Substance Use Disorder)0710102115VIRGINIANo
41041C0700XSocial WorkerClinical0904006954VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1=========MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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