| Organization Name: | THIMBLE SHOALS COUNSELING & THERAPY CENTER PC |
| NPI Number: | 1033138227 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN C NICHOLSON (OWNER, PRESIDENT) |
| Mailing Address: | 703 Thimble Shoals Blvd A3 Newport News |
| State: | VA US |
| Postal Code: | 236062576 |
| Phone Number: | 7578733401 |
| Fax Number: | 7572231165 |
| NPI Enumeration Date: | 07/19/2006 |
| NPI Last Update Date: | 06/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 0904003048 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |