Healthcare Provider Details

I. General information

NPI: 1598002818
Provider Name (Legal Business Name): STACEY Q JAMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5205 COMMONWEALTH CENTRE PKWY
MIDLOTHIAN VA
23112-2623
US

IV. Provider business mailing address

5205 COMMONWEALTH CENTRE PKWY
MIDLOTHIAN VA
23112-2623
US

V. Phone/Fax

Practice location:
  • Phone: 804-977-2770
  • Fax: 804-802-5614
Mailing address:
  • Phone: 804-977-2770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119005865
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: