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NPI Code Detail

MEDICARE: VIRGINIA ADDICTION MANAGEMENT LLC

MEDICARE: VIRGINIA ADDICTION MANAGEMENT LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2103TA0400XAddiction (Substance Use Disorder) Psychologist
3163WA0400XAddiction (Substance Use Disorder) Registered Nurse
4171M00000XCase Manager/Care Coordinator
5207RA0401XAddiction Medicine (Internal Medicine) Physician
6207ZP0105XClinical Pathology/Laboratory Medicine Physician
72084A0401XAddiction Medicine (Psychiatry & Neurology) Physician
8208D00000XGeneral Practice Physician
9207QA0401XAddiction Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1780166777
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIRGINIA ADDICTION MANAGEMENT LLC
Provider Business Mailing Address
First Line : 2281 VALLEY AVE
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-2755
Country : US
Telephone Number : 540-278-2228
Fax Number : 866-279-1155
Provider Business Practice Location Address
First Line : 2281 VALLEY AVE
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-2755
Country : US
Telephone Number : 540-278-2228
Fax Number : 866-279-1155
Authorized Official
Title or Position : CHIEF OPERATIONS OFFICER
Name : MS. GABRIELE WHYARD
Credential :
Telephone Number : 540-278-2228
Provider Enumeration Date : 09/05/2018
Last Update Date : 08/17/2021

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Directions to “VIRGINIA ADDICTION MANAGEMENT LLC ” Practice Location

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