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General NPI Number Information
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NPI Number | 1093826109
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Entity Type | Organization
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Legal Business Name | ADOLESCENT AND FAMILY INSTITUTE, INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 142 W YORK ST SUITE 402
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City | NORFOLK
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State | VA
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Zip | 23510-2015
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Country | US
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Telephone | 757-466-0946
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Fax | 757-466-0947
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Provider Business Mailing Address
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Address Line | 142 W YORK ST STE 308
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City | NORFOLK
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State | VA
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Zip | 23510-2047
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Country | US
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Telephone | 757-466-0946
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Fax | 757-466-0947
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. RICHARD BURNEY
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Credential | MA
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Telephone | 757-466-0946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904004800
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License Number State | VA
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