MEDICARE: TALK FAMILY OF VIRGINIA

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
1	251S00000X	Community/Behavioral Health Agency	1567	VA

General Provider Information

NPI Number	:	1881901171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TALK FAMILY OF VIRGINIA

Provider Business Mailing Address
First Line	:	2117 SPRINGFIELD AVE
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23523-2436
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2117 SPRINGFIELD AVE
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23523-2436
Country	:	US
Telephone Number	:	757-748-8882
Fax Number	:	757-431-9225

Authorized Official
Title or Position	:	CEO
Name	:	MR. KEVIN LARON WALTON SR.
Credential	:
Telephone Number	:	757-748-8882

Provider Enumeration Date	:	09/08/2010
Last Update Date	:	09/08/2010

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Directions to “TALK FAMILY OF VIRGINIA ” Practice Location

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