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General NPI Number Information
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NPI Number | 1225856008
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Entity Type | Organization
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Legal Business Name | AEVUM BH VA LLC
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 4403 FOREST HILL AVE
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City | RICHMOND
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State | VA
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Zip | 23225-3241
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Country | US
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Telephone | 848-210-0028
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Fax |
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Provider Business Mailing Address
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Address Line | 440 SYLVAN AVE STE 240
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-2700
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Country | US
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Telephone | 804-446-1710
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. LEVI LIPOVENKO
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Credential | PSYD
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Telephone | 804-446-1710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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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 | 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 #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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