COLONIAL PSYCHIATRIC ASSOCIATES LLC NPI 1235636069

NPI Information

NPI: 1235636069
Provider Name: COLONIAL PSYCHIATRIC ASSOCIATES, LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 49D1079126

Address:
708 MOBJACK PL
NEWPORT NEWS, VA
ZIP 23606
Phone: (757) 873-1958
Get Directions

COLONIAL PSYCHIATRIC ASSOCIATES, LLC is a mental health (including community mental health center) clinic center in Newport News, VA. COLONIAL PSYCHIATRIC ASSOCIATES, LLC NPI is 1235636069. The provider is registered as an organization entity type.

The provider's business location address is:

708 MOBJACK PL
NEWPORT NEWS, VA
ZIP 23606-957
Phone: (757) 873-1958
Fax: (757) 873-2143

The provider's authorized official is Wendy Burch .
The authorized official title is Office Manager and has the following contact phone number (757) 873-1958.

The CLIA number assigned to this NPI record is 49D1079126 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/9/2018 and was last updated on 4/9/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

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This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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