Provider Demographics
NPI:1033984828
Name:MENTAL HEALTH SOLUTION
Entity Type:Organization
Organization Name:MENTAL HEALTH SOLUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:COWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-581-3897
Mailing Address - Street 1:3615 VICTORY BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23701-3419
Mailing Address - Country:US
Mailing Address - Phone:757-581-3897
Mailing Address - Fax:
Practice Address - Street 1:3615 VICTORY BLVD STE 105
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701-3419
Practice Address - Country:US
Practice Address - Phone:757-581-3897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty