Healthcare Provider Details

I. General information

NPI: 1760297436
Provider Name (Legal Business Name): SUSAN M BRICK PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 GREENBRIER CIR STE 100
CHESAPEAKE VA
23320-2645
US

IV. Provider business mailing address

816 GREENBRIER CIR STE 100
CHESAPEAKE VA
23320-2645
US

V. Phone/Fax

Practice location:
  • Phone: 844-863-4621
  • Fax: 757-301-8803
Mailing address:
  • Phone: 844-863-4621
  • Fax: 757-301-8803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001276750
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024192492
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: