Healthcare Provider Details

I. General information

NPI: 1497418453
Provider Name (Legal Business Name): ALYSSA PIEDRAHITA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 PROFESSIONAL RD
NORTH CHESTERFIELD VA
23235-3214
US

IV. Provider business mailing address

4008 W BROAD ST APT 432
RICHMOND VA
23230-3988
US

V. Phone/Fax

Practice location:
  • Phone: 804-592-6311
  • Fax:
Mailing address:
  • Phone: 203-598-2258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP016675
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904018429
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: