=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942003306
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AADIRAYANA JOSEPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2025
-----------------------------------------------------
Last Update Date | 03/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 901 HAMPTON BLVD STE 301
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23507-1503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-934-3936
-----------------------------------------------------
Fax | 617-807-0958
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 748465
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30374-8465
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-284-7483
-----------------------------------------------------
Fax | 617-807-0958
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 0906015563
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------