Healthcare Provider Details
I. General information
NPI: 1821963927
Provider Name (Legal Business Name): MENTAL HEALTH SERVICES OF VIRGINIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5604 VIRGINIA BEACH BLVD STE 101A
VIRGINIA BEACH VA
23462-5631
US
IV. Provider business mailing address
5604 VIRGINIA BEACH BLVD STE 101A
VIRGINIA BEACH VA
23462-5631
US
V. Phone/Fax
- Phone: 757-455-5000
- Fax:
- Phone: 757-455-5000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSHUA
ADLER
Title or Position: OWNER, COO
Credential:
Phone: 757-455-5000