Provider Demographics
NPI:1053891705
Name:WINTERS, MAE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:MAE
Middle Name:MARIE
Last Name:WINTERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 ROSE GALAXY LNDG APT 301
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-7773
Mailing Address - Country:US
Mailing Address - Phone:757-754-4475
Mailing Address - Fax:
Practice Address - Street 1:721 SPARROW RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23325-2506
Practice Address - Country:US
Practice Address - Phone:757-689-7971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health