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General NPI Number Information
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NPI Number | 1417204512
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH CONSULTANTS OF HAMPTON ROADS LLC
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 08/07/2012
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Provider Practice Location Address
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Address Line | 5109 GOLDSBORO DR 3B
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City | NEWPORT NEWS
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State | VA
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Zip | 23605-1301
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Country | US
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Telephone | 757-218-5974
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Fax |
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Provider Business Mailing Address
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Address Line | 5109 GOLDSBORO DR 3B
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City | NEWPORT NEWS
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State | VA
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Zip | 23605-1301
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Country | US
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Telephone | 757-218-5974
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MS. SHAWNDRA UMBRAGE
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Credential | LEMHP
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Telephone | 757-218-5974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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