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General NPI Number Information
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NPI Number | 1043119118
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Entity Type | Organization
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Legal Business Name | ABUNDANT LIFE TELEPSYCHIATRY LLC
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 11607 BIRDIE LN
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City | CHESTER
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State | VA
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Zip | 23831-1690
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Country | US
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Telephone | 610-568-5776
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Fax |
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Provider Business Mailing Address
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Address Line | 11607 BIRDIE LN
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City | CHESTER
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State | VA
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Zip | 23831-1690
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER/CEO
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Name | CHERESHA SAMUELS
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Credential | DNP,FNP-C,PMHNP-C
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Telephone | 804-489-1545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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