Provider Demographics
NPI:1366143463
Name:POOLE, ROSHONDA (MSW)
Entity type:Individual
Prefix:MS
First Name:ROSHONDA
Middle Name:
Last Name:POOLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 CASON LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1198
Mailing Address - Country:US
Mailing Address - Phone:757-561-8759
Mailing Address - Fax:
Practice Address - Street 1:5267 GREENWICH RD STE 101E
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6028
Practice Address - Country:US
Practice Address - Phone:757-206-2378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health