=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043066855
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | IT IS WELL PSYCHIATRY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2024
-----------------------------------------------------
Last Update Date | 07/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 267 ALLEGHANY SPRING RD
-----------------------------------------------------
City | SHAWSVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24162-1801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-449-2508
-----------------------------------------------------
Fax | 540-849-1820
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 356 BERNIES WAY
-----------------------------------------------------
City | ELLISTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24087-1401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-449-2508
-----------------------------------------------------
Fax | 540-849-1820
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JULIA PRICE MOORE
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 540-449-2508
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------