Provider Demographics
NPI:1124908397
Name:SHORELINE COUNSELING & HEALING LLC
Entity type:Organization
Organization Name:SHORELINE COUNSELING & HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIME
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-769-4417
Mailing Address - Street 1:744 WILLOW LAKE CIR APT 115
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7959
Mailing Address - Country:US
Mailing Address - Phone:757-769-4417
Mailing Address - Fax:
Practice Address - Street 1:744 WILLOW LAKE CIR APT 115
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7959
Practice Address - Country:US
Practice Address - Phone:757-769-4417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-06
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)