Healthcare Provider Details

I. General information

NPI: 1033055702
Provider Name (Legal Business Name): COMMONWEALTH BEHAVIORAL HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1548A HOLLAND RD STE 201
SUFFOLK VA
23434-6500
US

IV. Provider business mailing address

1548A HOLLAND RD STE 201
SUFFOLK VA
23434-6500
US

V. Phone/Fax

Practice location:
  • Phone: 757-276-1724
  • Fax:
Mailing address:
  • Phone: 757-276-1724
  • 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: KEIRA MOORE MAJEED
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 757-276-1724