Healthcare Provider Details

I. General information

NPI: 1073650099
Provider Name (Legal Business Name): CITY OF CHESAPEAKE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 GREAT BRIDGE BLVD CHESAPEAKE COMMUNITY SERVICES BOARD
CHESAPEAKE VA
23320-3904
US

IV. Provider business mailing address

224 GREAT BRIDGE BLVD
CHESAPEAKE VA
23320-3904
US

V. Phone/Fax

Practice location:
  • Phone: 757-547-9334
  • Fax: 757-819-6292
Mailing address:
  • Phone: 757-547-9334
  • Fax: 757-210-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number141 16 001
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number141
License Number StateVA

VIII. Authorized Official

Name: DEBORAH CHAMBLISS
Title or Position: REIMBURSEMENT SUPERVISOR
Credential:
Phone: 757-819-6392