Healthcare Provider Details

I. General information

NPI: 1336574581
Provider Name (Legal Business Name): NEW PROGRESSIONS OF VIRGINIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2013
Last Update Date: 09/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COLUMBUS CTR SUITE 600
VIRGINIA BEACH VA
23462-6722
US

IV. Provider business mailing address

620 GUILFORD COLLEGE RD SUITE G
GREENSBORO NC
27409-2292
US

V. Phone/Fax

Practice location:
  • Phone: 336-254-6770
  • Fax:
Mailing address:
  • Phone: 336-254-6770
  • 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: MR. GEOVON K MARTIN
Title or Position: CEO/DRECTOR
Credential: B.S.
Phone: 336-254-6770