Provider Demographics
NPI:1093118010
Name:SALANT, MICHAEL PETER (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:PETER
Last Name:SALANT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 HILLTOP WEST SHOPPING CTR STE 215
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6141
Mailing Address - Country:US
Mailing Address - Phone:757-366-1234
Mailing Address - Fax:757-932-5432
Practice Address - Street 1:1604 HILLTOP WEST SHOPPING CTR STE 215
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6141
Practice Address - Country:US
Practice Address - Phone:757-366-1234
Practice Address - Fax:757-932-5432
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040099841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical