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General NPI Number Information
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NPI Number | 1558184275
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Entity Type | Organization
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Legal Business Name | MENTAL BALANCE LLC
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 4445 CORPORATION LN STE 264
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3671
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Country | US
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Telephone | 703-214-4894
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Fax |
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Provider Business Mailing Address
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Address Line | 15000 POTOMAC TOWN PL STE 100
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City | WOODBRIDGE
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State | VA
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Zip | 22191-6587
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Country | US
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Telephone | 502-435-1644
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Fax | 757-952-6981
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Authorized Official
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Title or Position | PMHNP
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Name | JEWELLE ROBINSON
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Credential |
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Telephone | 502-435-1644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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