Provider Demographics
NPI:1649092784
Name:WHITE, CEAZIA (QMHPA/ QMHP-C)
Entity type:Individual
Prefix:
First Name:CEAZIA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:QMHPA/ QMHP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 REFLECTIONS DR APT 201
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-8338
Mailing Address - Country:US
Mailing Address - Phone:757-452-8331
Mailing Address - Fax:
Practice Address - Street 1:345 REFLECTIONS DR APT 201
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-8338
Practice Address - Country:US
Practice Address - Phone:757-452-8331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0733000895101YM0800X
VA0732006222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health