Healthcare Provider Details

I. General information

NPI: 1093118051
Provider Name (Legal Business Name): BEHAVIORAL HEALTH PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2014
Last Update Date: 05/17/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 N COURTHOUSE RD STE 101
NORTH CHESTERFIELD VA
23236-4069
US

IV. Provider business mailing address

703 N COURTHOUSE RD STE 101
NORTH CHESTERFIELD VA
23236-4069
US

V. Phone/Fax

Practice location:
  • Phone: 804-794-4482
  • Fax: 804-379-7578
Mailing address:
  • Phone: 804-794-4482
  • Fax: 804-379-7578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE JONES
Title or Position: OFFICE MANAGER
Credential:
Phone: 804-794-4482