Healthcare Provider Details

I. General information

NPI: 1811815210
Provider Name (Legal Business Name): GENERATION PSYCHIATRIC RESILIENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MAYLAND DR STE S
RICHMOND VA
23294-4648
US

IV. Provider business mailing address

8401 MAYLAND DR STE S
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 804-800-3930
  • Fax: 434-333-7495
Mailing address:
  • Phone: 804-800-3930
  • Fax: 434-333-7495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TABITHA GREGORY
Title or Position: PMHNP
Credential:
Phone: 434-944-4521