Provider Demographics
NPI:1477002319
Name:RUMPH, STANDICE (LPC)
Entity Type:Individual
Prefix:
First Name:STANDICE
Middle Name:
Last Name:RUMPH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:STANDICE
Other - Middle Name:RUMPH
Other - Last Name:MELVIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:522 S INDEPENDENCE BLVD
Mailing Address - Street 2:ST. 201
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1149
Mailing Address - Country:US
Mailing Address - Phone:757-943-0355
Mailing Address - Fax:757-337-0622
Practice Address - Street 1:522 S INDEPENDENCE BLVD
Practice Address - Street 2:ST. 201
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1149
Practice Address - Country:US
Practice Address - Phone:757-943-0355
Practice Address - Fax:757-337-0622
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006715101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional