Healthcare Provider Details

I. General information

NPI: 1750884813
Provider Name (Legal Business Name): FAMILY INSIGHT THERAPEUTIC SERVICES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2018
Last Update Date: 06/16/2020
Certification Date: 06/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 N CENTER DR STE 200
NORFOLK VA
23502-4008
US

IV. Provider business mailing address

7113 THREE CHOPT RD STE 301
RICHMOND VA
23226-3643
US

V. Phone/Fax

Practice location:
  • Phone: 757-233-0003
  • Fax: 757-233-1669
Mailing address:
  • Phone: 804-562-9997
  • Fax: 804-562-9742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK THOMAS PHILLIPS
Title or Position: DIRECTOR OF FINANCE AND ACCOUNTING
Credential:
Phone: 804-562-9997