Healthcare Provider Details
I. General information
NPI: 1639971732
Provider Name (Legal Business Name): ARCHER CONSULTANT GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2025
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3506 E BROAD ST
RICHMOND VA
23223-8004
US
IV. Provider business mailing address
3506 E BROAD ST
RICHMOND VA
23223-8004
US
V. Phone/Fax
- Phone: 804-218-8182
- Fax: 480-287-8222
- Phone: 804-218-8182
- Fax: 480-287-8222
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0100X |
| Taxonomy | Health Service Psychologist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084B0040X |
| Taxonomy | Behavioral Neurology & Neuropsychiatry Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TEVAR
MARKEL
ARCHER
Title or Position: PRESIDENT
Credential:
Phone: 804-218-8182