Healthcare Provider Details

I. General information

NPI: 1174434583
Provider Name (Legal Business Name): RYLEE STONEMAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3207 CHURCHLAND BLVD
CHESAPEAKE VA
23321-5205
US

IV. Provider business mailing address

2713 DEERFIELD CRES
CHESAPEAKE VA
23321-2447
US

V. Phone/Fax

Practice location:
  • Phone: 757-956-6100
  • Fax: 757-956-6101
Mailing address:
  • Phone: 757-956-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701016770
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: