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General NPI Number Information
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NPI Number | 1457785388
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Entity Type | Organization
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Legal Business Name | VIRGINIA INTERVENTIONAL PSYCHIATRY
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Dates
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Enumeration Date | 08/28/2013
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 5231 HICKORY PARK DR SUITE C
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City | GLEN ALLEN
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State | VA
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Zip | 23059-2619
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Country | US
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Telephone | 804-980-7529
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Fax | 804-980-7794
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Provider Business Mailing Address
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Address Line | 5231 HICKORY PARK DR STE C
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City | GLEN ALLEN
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State | VA
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Zip | 23059-2619
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Country | US
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Telephone | 804-464-8471
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Fax | 804-980-7794
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | BRYCE NEUMANN
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Credential |
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Telephone | 804-980-7520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101235202
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License Number State | VA
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