Healthcare Provider Details

I. General information

NPI: 1912796772
Provider Name (Legal Business Name): S&D BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 BENSLEY PARK BLVD
NORTH CHESTERFIELD VA
23237-1787
US

IV. Provider business mailing address

7301 BENSLEY PARK BLVD
NORTH CHESTERFIELD VA
23237-1787
US

V. Phone/Fax

Practice location:
  • Phone: 646-523-1480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: NATACHA WILLIAMS
Title or Position: BILLER/CREDENTIALER
Credential:
Phone: 757-608-9255