Healthcare Provider Details

I. General information

NPI: 1295315612
Provider Name (Legal Business Name): OCEAN REINS BEHAVIORAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 CORPORATION LN STE 199B
VIRGINIA BEACH VA
23462-3262
US

IV. Provider business mailing address

4445 CORPORATION LN STE 199B
VIRGINIA BEACH VA
23462-3262
US

V. Phone/Fax

Practice location:
  • Phone: 572-045-7757
  • Fax: 757-257-2320
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAMIE DEPUTY
Title or Position: PMHNP
Credential: PMHNP-BC
Phone: 757-204-5775