Provider Demographics
NPI:1770278764
Name:WRITERS' BLOQ THERAPEUTIC SOLUTIONS, LLC.
Entity type:Organization
Organization Name:WRITERS' BLOQ THERAPEUTIC SOLUTIONS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEX THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JAVAIL
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, CFT
Authorized Official - Phone:804-455-7283
Mailing Address - Street 1:110 COLISEUM XING # 5395
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5971
Mailing Address - Country:US
Mailing Address - Phone:804-455-7283
Mailing Address - Fax:804-460-6827
Practice Address - Street 1:4410 EAST CLAIBORNE STREET
Practice Address - Street 2:SUITE 334
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666
Practice Address - Country:US
Practice Address - Phone:804-455-7283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty