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General NPI Number Information
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NPI Number | 1235857608
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Entity Type | Organization
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Legal Business Name | ANCHORED IN HOPE, LLC.
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 128 RON SPRINGS DRIVE 1524 MERRIMAC TRAIL
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City | WILLIAMSBURG
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State | VA
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Zip | 23185
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Country | US
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Telephone | 757-746-5094
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Fax | 757-964-1215
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Provider Business Mailing Address
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Address Line | 1706 TODDS LN # 342
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City | HAMPTON
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State | VA
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Zip | 23666-3123
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Country | US
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Telephone | 757-746-5094
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Fax | 757-964-1215
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Authorized Official
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Title or Position | COO
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Name | KELLI BAYLOR
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Credential | LCSW
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Telephone | 757-746-5094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 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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