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General NPI Number Information
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NPI Number | 1073161956
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH ASSOCIATES OF VIRGINIA
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 11030 WARWICK BLVD STE A
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-3251
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Country | US
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Telephone | 757-534-9088
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Fax | 757-534-7496
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Provider Business Mailing Address
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Address Line | 4196 MERCHANT PLZ STE 205
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City | WOODBRIDGE
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State | VA
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Zip | 22192-5085
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Country | US
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Telephone | 804-721-7528
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. RICHARD ERIC ROMAN
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Credential |
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Telephone | 804-721-7528
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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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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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