Healthcare Provider Details

I. General information

NPI: 1548176522
Provider Name (Legal Business Name): ADJUVANT BEHAVIORAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 COX RD STE 200
GLEN ALLEN VA
23060-9248
US

IV. Provider business mailing address

11754 JOLLYVILLE RD STE 110
AUSTIN TX
78759-3948
US

V. Phone/Fax

Practice location:
  • Phone: 866-912-2746
  • Fax: 800-420-2305
Mailing address:
  • Phone: 866-912-2746
  • Fax: 800-420-2305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JIMMY MYERS
Title or Position: CCO
Credential: PHD, LPC-S
Phone: 866-912-2746