MEDICARE: SJW BEHAVIORAL HEALTH NETWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1326990789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SJW BEHAVIORAL HEALTH NETWORK

Provider Business Mailing Address
First Line	:	120 N PLAINS DR
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23805-9110
Country	:	US
Telephone Number	:	804-439-9453
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 N PLAINS DR
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23805-9110
Country	:	US
Telephone Number	:	804-439-9453
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SIMMONE JOY WILLIAMS
Credential	:	QMHP, A.C, MA
Telephone Number	:	804-439-9453

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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