Provider Demographics
NPI:1336925270
Name:CALM SOUL WELLNESS, LLC
Entity Type:Organization
Organization Name:CALM SOUL WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OUTPATIENT THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NEFERTARI
Authorized Official - Middle Name:JUNE
Authorized Official - Last Name:BRITTO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, NCC
Authorized Official - Phone:757-600-7556
Mailing Address - Street 1:4701 SHORE DRIVE,
Mailing Address - Street 2:STE 103-#159
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455
Mailing Address - Country:US
Mailing Address - Phone:757-635-9009
Mailing Address - Fax:
Practice Address - Street 1:4410 CLAIRBORNE SQ EAST
Practice Address - Street 2:SUITE 334-#1512
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666
Practice Address - Country:US
Practice Address - Phone:757-635-9009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty