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WELLNESS PROVIDER SERVICES LLC
NPI 1942005335
Nurse Practitioner - Psychiatric/Mental Health in Virginia Beach, VA

Active since February 18, 2025
780 LYNNHAVEN PKWY STE 400, VIRGINIA BEACH, VA 23452(757) 650-1762 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 10, 2025, Feb 18, 2025 (2 updates tracked since 2025).

About Wellness Provider Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WELLNESS PROVIDER SERVICES LLC (NPI 1942005335) is a healthcare organization registered as a psychiatric/mental health in Virginia Beach, Virginia and active in the NPI registry since February 2025. The organization maintains a secondary practice location in Virginia Beach and lists Tera Stanistreet, Manager, as its authorized official.

NPPES Registry Identity

NPI1942005335
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameWELLNESS PROVIDER SERVICES LLC
Location Address780 LYNNHAVEN PKWY STE 400Virginia Beach, VA 23452-7332
Mailing Address780 Lynnhaven Pkwy Ste 400Virginia Beach, VA 23452-7332 · (757) 650-1762
Phone(757) 650-1762
Organization SubpartNo
Authorized OfficialTera StanistreetManager · (757) 650-1762
Enumeration DateFebruary 18, 2025
Last NPPES UpdateMarch 10, 20252 updates tracked since enumeration
NPPES CertifiedMarch 10, 2025
✔ NPI 1942005335 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
780 LYNNHAVEN PKWY STE 400, Virginia Beach, VA 23452
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Secondary Practice Location 1

Location 11209 Moorefield CtVirginia Beach, VA 23454-2210 · Phone (757) 650-1762

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARKIA JAYLAN DURR
Behavior Technician
780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH, VA 23452
Virginia Beach City (708) 890-4647
DESTINY MCCADEN
Behavior Technician
780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH, VA 23452
Virginia Beach City (888) 880-9270
CAMISHA MANN
Behavior Technician
780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH, VA 23452
Virginia Beach City (877) 418-2978
ZYON WILSON
Behavior Technician
780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH, VA 23452
Virginia Beach City (888) 880-9270
CAYLA CAMMETT
Behavior Technician
780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH, VA 23452
Virginia Beach City (888) 880-9270
DEAISHA SHAPREE VENABLE
Behavior Technician
780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH, VA 23452
Virginia Beach City (877) 418-2978
SHAKERA A JACKMAN-WATTS
Behavior Technician
780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH, VA 23452
Virginia Beach City (877) 418-2978
JENNIFER MILES
Behavior Technician
780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH, VA 23452
Virginia Beach City (877) 418-2978

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wellness Provider Services LLC's NPI number?

The NPI number for Wellness Provider Services LLC is 1942005335. It was assigned to this organization in the NPPES registry on February 18, 2025.

Where is Wellness Provider Services LLC located?

Wellness Provider Services LLC is located at 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452. The listed phone number is (757) 650-1762.

What is Wellness Provider Services LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Wellness Provider Services LLC was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.