Healthcare Provider Details

I. General information

NPI: 1336891043
Provider Name (Legal Business Name): SONYA CHILES R-CPRS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 04/26/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 TRAFTON ST
RICHMOND VA
23222-2036
US

IV. Provider business mailing address

1401 NELSON ST
RICHMOND VA
23231-3721
US

V. Phone/Fax

Practice location:
  • Phone: 804-258-0691
  • Fax:
Mailing address:
  • Phone: 804-637-0502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: