Healthcare Provider Details

I. General information

NPI: 1063249670
Provider Name (Legal Business Name): ANGER MANAGEMENT HAMPTON ROADS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 KEMPSVILLE RD STE F
CHESAPEAKE VA
23320-3643
US

IV. Provider business mailing address

4224 QUAILSHIRE CT
CHESAPEAKE VA
23321-3197
US

V. Phone/Fax

Practice location:
  • Phone: 757-589-0293
  • Fax:
Mailing address:
  • Phone: 757-589-0293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES ALLEN JOHNSON JR.
Title or Position: PARTNER
Credential: ED.S, MDIV, LMFT
Phone: 757-589-0293