Healthcare Provider Details

I. General information

NPI: 1306578471
Provider Name (Legal Business Name): CHARLOTTESVILLE PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 12/23/2022
Certification Date: 12/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 S PANTOPS DR STE 303
CHARLOTTESVILLE VA
22911-8673
US

IV. Provider business mailing address

175 S PANTOPS DR STE 303
CHARLOTTESVILLE VA
22911-8673
US

V. Phone/Fax

Practice location:
  • Phone: 434-328-8787
  • Fax: 434-328-8765
Mailing address:
  • Phone: 434-328-8787
  • Fax: 434-328-8765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW J CHAMBERS
Title or Position: MEMBER
Credential: MD
Phone: 434-328-8787