Healthcare Provider Details

I. General information

NPI: 1548023625
Provider Name (Legal Business Name): NEW SEASONS FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11000 WOOFERTON CT
MIDLOTHIAN VA
23112-1664
US

IV. Provider business mailing address

11000 WOOFERTON CT
MIDLOTHIAN VA
23112-1664
US

V. Phone/Fax

Practice location:
  • Phone: 804-803-4075
  • Fax:
Mailing address:
  • Phone: 804-803-4075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. RODERICK HAMPTON II
Title or Position: C.E.O/ CLINICIAN
Credential: LPC, NCC
Phone: 804-245-3353