Healthcare Provider Details

I. General information

NPI: 1669846713
Provider Name (Legal Business Name): ESIRI, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2015
Last Update Date: 07/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 E VIRGINIA BEACH BLVD SUITE104
NORFOLK VA
23502-2530
US

IV. Provider business mailing address

5900 E VIRGINIA BEACH BLVD EXECUTIVE BUILDING SUITE 104
NORFOLK VA
23502-2530
US

V. Phone/Fax

Practice location:
  • Phone: 757-575-0811
  • Fax: 855-450-0830
Mailing address:
  • Phone: 757-575-0811
  • Fax: 855-450-0830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. CHEVETTE SCOTT ALSTON
Title or Position: CEO/CLINICAL PSYCHOLOGIST
Credential: PSYD, NCC, LPC
Phone: 757-575-0811