Healthcare Provider Details

I. General information

NPI: 1205371663
Provider Name (Legal Business Name): SIMPLE SOLUTIONS PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2016
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 KANIPE CT
RICHMOND VA
23228
US

IV. Provider business mailing address

4321 KANIPE CT
RICHMOND VA
23228
US

V. Phone/Fax

Practice location:
  • Phone: 804-657-7775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KIM VU
Title or Position: MANAGER, OWNER
Credential: NP
Phone: 804-677-8452