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General NPI Number Information
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NPI Number | 1306157243
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Entity Type | Organization
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Legal Business Name | NEW SEASON CLINICAL SERVICES
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 06/25/2010
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Provider Practice Location Address
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Address Line | 1613 HARDY CASH DR
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City | HAMPTON
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State | VA
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Zip | 23666-2414
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Country | US
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Telephone | 757-595-2727
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Fax | 757-595-2776
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Provider Business Mailing Address
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Address Line | 1613 HARDY CASH DR
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City | HAMPTON
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State | VA
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Zip | 23666-2414
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Country | US
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Telephone | 757-595-2727
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Fax | 757-595-2776
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. DELORES THOMAS
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Credential | LCSW
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Telephone | 757-595-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 113903001
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License Number State | VA
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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 | 113905001
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License Number State | VA
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