Healthcare Provider Details

I. General information

NPI: 1881524940
Provider Name (Legal Business Name): RIVERS HEALTH & FAMILY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 EXECUTIVE DR STE 370
HAMPTON VA
23666-2404
US

IV. Provider business mailing address

2101 EXECUTIVE DR STE 370
HAMPTON VA
23666-2404
US

V. Phone/Fax

Practice location:
  • Phone: 757-805-7434
  • Fax: 757-805-7434
Mailing address:
  • Phone: 757-805-7434
  • Fax: 757-805-7434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JAMELLE MASON
Title or Position: CEO
Credential:
Phone: 757-805-7434