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General NPI Number Information
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NPI Number | 1417801572
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Entity Type | Organization
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Legal Business Name | WAYSIDE PSYCHIATRY & WELLNESS, PLLC
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Dates
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Enumeration Date | 02/25/2026
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 8401 MAYLAND DR STE S
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City | RICHMOND
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State | VA
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Zip | 23294-4648
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Country | US
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Telephone | 804-819-9157
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Fax |
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Provider Business Mailing Address
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Address Line | 8334 RAVEN RUN DR
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-6556
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Country | US
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Telephone | 804-819-9157
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LATANE FLANAGAN
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Credential | PMHNP-BC
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Telephone | 804-819-9157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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