Healthcare Provider Details
I. General information
NPI: 1366082125
Provider Name (Legal Business Name): FOCUSED PSYCHIATRIC AND MENTAL HEALTH CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2020
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1801 S CHURCH ST STE 4
SMITHFIELD VA
23430-1858
US
IV. Provider business mailing address
1801 S CHURCH ST STE 4
SMITHFIELD VA
23430-1858
US
V. Phone/Fax
- Phone: 757-793-9483
- Fax:
- Phone: 757-793-9483
- Fax: 757-793-9483
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANGELA
MARIE
ALLEN
Title or Position: OWNER
Credential: PMHNP-BC, FNP-BC
Phone: 757-793-9483