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General NPI Number Information
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NPI Number | 1710576343
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Entity Type | Organization
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Legal Business Name | VISIONS OF HOPE PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 01/18/2021
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 555 SOUTHLAKE BLVD UNIT C2
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-3060
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Country | US
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Telephone | 804-592-0491
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Fax |
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Provider Business Mailing Address
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Address Line | 555 SOUTHLAKE BLVD UNIT C2
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-3060
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Country | US
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Telephone | 804-592-0491
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | SELISHA NELSON
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Credential | PH.D, LCP
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Telephone | 804-592-0491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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