Healthcare Provider Details

I. General information

NPI: 1598660656
Provider Name (Legal Business Name): BEHAVIORAL HEALTH SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MAYLAND DR # 11858
RICHMOND VA
23294-4648
US

IV. Provider business mailing address

8401 MAYLAND DR # 11858
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 276-285-0314
  • Fax:
Mailing address:
  • Phone: 276-285-0314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. NICOLAS RAY WILSON
Title or Position: PLLC OWNER
Credential: PSY.D
Phone: 276-285-0314