OrganizationThimble Shoals Counseling & Therapy Center Pc(<Unavail>)Social WorkerBehavioral Health & Social Service ProvidersPractice Address703 Thimble Shoals Blvd, A3, Newport News, VA 23606-2576(757) 873-3401(757) 869-2361PECOS EnrollmentBased on the most recent information from CMS, provider Thimble Shoals Counseling & Therapy Center Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1033138227Provider TypeOrganizationFull NameThimble Shoals Counseling & Therapy Center PcOther Name<Unavail>SubpartNoEnumeration Date7/19/2006Last Updated6/25/2008Contact InformationPractice LocationPractice Address703 Thimble Shoals Blvd, A3, Newport News, VA 23606-2576Phone(757) 873-3401Fax(757) 223-1165Mailing LocationMailing Address203 Woodburne Ln, Newport News, VA 23602-8363Phone(757) 869-2361Fax(757) 223-1165Authorized OfficialNameNicholson, Susan C (Owner, President)Phone(757) 869-2361Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense0904003048VirginiaProvider IdentifiersIDDescriptionIssuerID228979000DescriptionOtherIssuerMAGELLANVirginiaID567827DescriptionOtherIssuerMAMSIVirginiaID5774587DescriptionOtherIssuerAETNAVirginiaID1033138227DescriptionMedicaidIssuerUnlistedVirginiaID034810DescriptionOtherIssuerVALUE OPTIONSVirginiaID118556DescriptionOtherIssuerANTHEMVirginiaID118556DescriptionOtherIssuerHEALTHKEEPERSVirginiaID081419DescriptionOtherIssuerSENTARAVirginiaID2130368DescriptionOtherIssuerCIGNAID413584DescriptionOtherIssuerMHNVirginia