Provider Demographics
NPI:1023458684
Name:AVISO CONSULTING & PSYCHOTHERAPY SOLUTIONS, LLC
Entity type:Organization
Organization Name:AVISO CONSULTING & PSYCHOTHERAPY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:V
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-777-3710
Mailing Address - Street 1:999 WATERSIDE DR
Mailing Address - Street 2:STE 2525
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-3300
Mailing Address - Country:US
Mailing Address - Phone:757-777-3710
Mailing Address - Fax:
Practice Address - Street 1:999 WATERSIDE DR
Practice Address - Street 2:STE 2525
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-3300
Practice Address - Country:US
Practice Address - Phone:757-777-3710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040025891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty