Healthcare Provider Details

I. General information

NPI: 1578513784
Provider Name (Legal Business Name): JAMES RIVER PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 MOOREFIELD PARK DR SUITE 200
RICHMOND VA
23236-3657
US

IV. Provider business mailing address

720 MOOREFIELD PARK DR SUITE 200
RICHMOND VA
23236-3657
US

V. Phone/Fax

Practice location:
  • Phone: 804-272-7611
  • Fax: 804-560-5574
Mailing address:
  • Phone: 804-272-7611
  • Fax: 804-560-5574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: RONALD C MOYER
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 804-272-7611