Healthcare Provider Details

I. General information

NPI: 1164515821
Provider Name (Legal Business Name): PHILLIPS & ROSE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7580 HOSPITAL DR SUTIE 201
GLOUCESTER VA
23061
US

IV. Provider business mailing address

7580 HOSPITAL DR SUTIE 201
GLOUCESTER VA
23061
US

V. Phone/Fax

Practice location:
  • Phone: 804-693-0810
  • Fax: 804-693-0211
Mailing address:
  • Phone: 804-693-0810
  • Fax: 804-693-0211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701003186
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701001615
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0810001810
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904001475
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904002000
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0701001424
License Number StateVA
# 7
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number0101033004
License Number StateVA
# 8
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number01077001643
License Number StateVA

VIII. Authorized Official

Name: DR. JOSEPH D. PHILLIPS
Title or Position: PRESIDENT/MEDICAL DIRECTOR
Credential: M.D.
Phone: 804-693-0810