Healthcare Provider Details

I. General information

NPI: 1750753596
Provider Name (Legal Business Name): BEHAVIORAL HEALTH ALTERNATIVES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 07/14/2024
Certification Date: 07/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N ROBINSON ST STE 300
RICHMOND VA
23220-4459
US

IV. Provider business mailing address

110 N ROBINSON ST STE 200
RICHMOND VA
23220-4460
US

V. Phone/Fax

Practice location:
  • Phone: 804-367-3777
  • Fax: 804-367-4209
Mailing address:
  • Phone: 804-367-3777
  • Fax: 804-367-4209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number0024172537
License Number StateVA

VIII. Authorized Official

Name: THARTA RENA KING
Title or Position: OWNER
Credential: NP
Phone: 804-367-7777