Provider Demographics
NPI:1033626577
Name:CAPITAL HEALTH GROUP
Entity Type:Organization
Organization Name:CAPITAL HEALTH GROUP
Other - Org Name:CAPITAL HEALTH GROUP, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:BURNETT
Authorized Official - Last Name:EASON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LPC
Authorized Official - Phone:804-248-0808
Mailing Address - Street 1:3306 HANES AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-2627
Mailing Address - Country:US
Mailing Address - Phone:804-248-0808
Mailing Address - Fax:
Practice Address - Street 1:2300 N LOMBARDY ST STE E
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-1518
Practice Address - Country:US
Practice Address - Phone:804-248-0808
Practice Address - Fax:804-340-6729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006866251S00000X
363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty