Healthcare Provider Details

I. General information

NPI: 1417807900
Provider Name (Legal Business Name): POSITIVE TRANSITIONS MENTAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1939 REPP CIR
HENRICO VA
23075-2433
US

IV. Provider business mailing address

1939 REPP CIR
HENRICO VA
23075-2433
US

V. Phone/Fax

Practice location:
  • Phone: 757-810-8221
  • Fax:
Mailing address:
  • Phone: 757-810-8221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: TIFFANY DAVIS
Title or Position: OWNER/EXECUTIVE DIRECTOR
Credential: BS, QMHP
Phone: 757-810-8221