Healthcare Provider Details

I. General information

NPI: 1598861387
Provider Name (Legal Business Name): COMPREHENSIVE PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2117 SMITH AVE SUITE B
CHESAPEAKE VA
23320-2519
US

IV. Provider business mailing address

2117 SMITH AVE SUITE B
CHESAPEAKE VA
23320-2519
US

V. Phone/Fax

Practice location:
  • Phone: 757-547-9007
  • Fax: 757-786-2805
Mailing address:
  • Phone: 757-937-3969
  • Fax: 757-548-1928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT VELASQUEZ
Title or Position: PRACTICE ADMINISTRATOR
Credential: DHSC
Phone: 757-937-3969