Healthcare Provider Details

I. General information

NPI: 1578837761
Provider Name (Legal Business Name): ENVISION FAMILY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2012
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E MAIN ST STE 1604
NORFOLK VA
23510-2206
US

IV. Provider business mailing address

500 E MAIN ST STE 1604
NORFOLK VA
23510-2206
US

V. Phone/Fax

Practice location:
  • Phone: 757-350-3020
  • Fax:
Mailing address:
  • Phone: 917-406-6763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MERCEDES SANTOS-BELL
Title or Position: CO-OWNER
Credential: LPC
Phone: 757-350-3020