Healthcare Provider Details

I. General information

NPI: 1801168356
Provider Name (Legal Business Name): ELDER INSIGHT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 01/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 MELVINS END
YORKTOWN VA
23693-2566
US

IV. Provider business mailing address

103 MELVINS END
YORKTOWN VA
23693-2566
US

V. Phone/Fax

Practice location:
  • Phone: 757-846-8237
  • Fax:
Mailing address:
  • Phone: 757-846-8237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0024168429
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number001500463
License Number StateVA

VIII. Authorized Official

Name: SARAH LYNNE SEMONES
Title or Position: CNS, NP
Credential: PMHCNS-BC, ANP-C
Phone: 757-846-8237