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General NPI Number Information
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NPI Number | 1245827070
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Entity Type | Organization
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Legal Business Name | GATEWAY MEDICAL & MENTAL HEALTHCARE, LLC
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Dates
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Enumeration Date | 12/28/2020
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 4037 TAYLOR RD STE C
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City | CHESAPEAKE
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State | VA
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Zip | 23321-5500
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Country | US
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Telephone | 757-394-1135
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Fax | 757-774-8221
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Provider Business Mailing Address
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Address Line | 4037 TAYLOR RD STE C
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City | CHESAPEAKE
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State | VA
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Zip | 23321-5500
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Country | US
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Telephone | 757-394-1135
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Fax | 757-774-8221
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CRYSTAL J JONES
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Credential | MSN, FNP-C
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Telephone | 757-769-4274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling 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 | 363L00000X
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Taxonomy Name | 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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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