Healthcare Provider Details
I. General information
NPI: 1518570043
Provider Name (Legal Business Name): IPSYCHS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2020
Last Update Date: 08/09/2025
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2400 OLD BRICK RD STE 138
GLEN ALLEN VA
23060
US
IV. Provider business mailing address
1920 DRESDEN DR NE UNIT 190025
BROOKHEVEN GA
30319
US
V. Phone/Fax
- Phone: 888-779-2470
- Fax:
- Phone: 888-779-2470
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
DOLIN
Title or Position: VICE PRESIDENT
Credential:
Phone: 888-779-2470