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General NPI Number Information
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NPI Number | 1588254684
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Entity Type | Organization
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Legal Business Name | A BRIGHTER JOURNEY
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Dates
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Enumeration Date | 01/22/2021
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Last Update Date | 01/22/2021
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Provider Practice Location Address
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Address Line | 13195 WARWICK BLVD STE 2E
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-8313
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Country | US
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Telephone | 757-527-3336
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Fax | 757-877-0509
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Provider Business Mailing Address
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Address Line | PO BOX 2214
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City | NEWPORT NEWS
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State | VA
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Zip | 23609-0214
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Country | US
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Telephone | 757-527-3336
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Fax | 757-827-0509
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Authorized Official
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Title or Position | CEO
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Name | MRS. LAKISHA BROUGHTON
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Credential | LPC
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Telephone | 757-214-2372
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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 |
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License Number State |
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