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General NPI Number Information
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NPI Number | 1316083165
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE COMMUNITY SERVICES BOARD
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 224 GREAT BRIDGE BLVD
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City | CHESAPEAKE
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State | VA
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Zip | 23320-3904
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Country | US
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Telephone | 757-547-9334
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Fax | 757-819-6189
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Provider Business Mailing Address
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Address Line | 224 GREAT BRIDGE BLVD
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City | CHESAPEAKE
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State | VA
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Zip | 23320-3904
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Country | US
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Telephone | 757-547-9334
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Fax | 757-819-6189
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Authorized Official
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Title or Position | STAFF PSYCHIATRIST
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Name | MS. INGRID SCHMEDTJE
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Credential | D.O.
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Telephone | 757-547-9334
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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 | 0102037220
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License Number State | VA
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