Healthcare Provider Details

I. General information

NPI: 1235857608
Provider Name (Legal Business Name): ANCHORED IN HOPE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 10/21/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 RON SPRINGS DRIVE 1524 MERRIMAC TRAIL
WILLIAMSBURG VA
23185
US

IV. Provider business mailing address

1706 TODDS LN # 342
HAMPTON VA
23666-3123
US

V. Phone/Fax

Practice location:
  • Phone: 757-746-5094
  • Fax: 757-964-1215
Mailing address:
  • Phone: 757-746-5094
  • Fax: 757-964-1215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KELLI BAYLOR
Title or Position: COO
Credential: LCSW
Phone: 757-746-5094