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General NPI Number Information
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NPI Number | 1538605613
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Entity Type | Organization
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Legal Business Name | CHESTERFIELD COUNTY MENTAL HEALTH
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Dates
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Enumeration Date | 01/12/2017
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Last Update Date | 01/12/2017
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Provider Practice Location Address
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Address Line | 6801 LUCY CORR CT
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City | CHESTERFIELD
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State | VA
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Zip | 23832-6657
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Country | US
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Telephone | 804-768-7215
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Fax | 804-796-7046
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Provider Business Mailing Address
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Address Line | PO BOX 92
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City | CHESTERFIELD
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State | VA
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Zip | 23832-0001
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Country | US
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Telephone | 804-768-7025
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DEBBIE BURCHAM
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Credential | RN
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Telephone | 804-768-7221
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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 | 0001231847
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License Number State | VA
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