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MIDDLE PENINSULA NORTHERN NECK MENTAL HEALTH & RETARDATION NPI 1497717615


NPI Information

NPI: 1497717615
Provider Name: MIDDLE PENINSULA NORTHERN NECK MENTAL HEALTH & RETARDATION

Other Name: MIDDLE PENINSULA NORTHERN NECK COUNSELING CENTER

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
9228 GEORGE WASHINGTON MEMORIAL HWY
GLOUCESTER, VA
ZIP 23061
Phone: (804) 693-5068
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MIDDLE PENINSULA NORTHERN NECK MENTAL HEALTH & RETARDATION is a mental health (including community mental health center) clinic center in Gloucester, VA. MIDDLE PENINSULA NORTHERN NECK MENTAL HEALTH & RETARDATION NPI is 1497717615. The provider is registered as an organization entity type.
The provider Other Name Is Middle Peninsula Northern Neck Counseling Center.

The provider's business location address is:

9228 GEORGE WASHINGTON MEMORIAL HWY
GLOUCESTER, VA
ZIP 23061-162
Phone: (804) 693-5068
Fax: (804) 693-7407

The provider's authorized official is Yvonne M Wingrove .
The authorized official title is Chief Financial Officer and has the following contact phone number (804) 693-5640.

The enumeration date for this NPI number is 4/4/2006 and was last updated on 6/21/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11497717615MEDICAIDVIRGINIA
2004945115MEDICAIDVIRGINIA
3250202OTHERVIRGINIAANTHEM
4250204OTHERVIRGINIAANTHEM
5250208OTHERVIRGINIAANTHEM
6=========OTHERVIRGINIAAETNA
7=========OTHERVIRGINIATRICARE
8=========OTHERVIRGINIACIGNA
9294721OTHERVIRGINIAVALUE OPTIONS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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