Healthcare Provider Details

I. General information

NPI: 1336220938
Provider Name (Legal Business Name): THERAPY ASSOCIATES OF DENBIGH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12725 MCMANUS BLVD BLDG 2 SUITE G
NEWPORT NEWS VA
23602-4402
US

IV. Provider business mailing address

12725 MCMANUS BLVD BLDG 2 SUITE G
NEWPORT NEWS VA
23602-4402
US

V. Phone/Fax

Practice location:
  • Phone: 757-874-1676
  • Fax: 757-874-2226
Mailing address:
  • Phone: 757-874-1676
  • Fax: 757-874-2226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. BETTIE A HAIGHT
Title or Position: OFFICE MANAGER
Credential:
Phone: 757-874-1676