Provider Demographics
NPI:1073613311
Name:ASSOCIATES IN MENTAL HEALTH SERVICES, P.C.
Entity Type:Organization
Organization Name:ASSOCIATES IN MENTAL HEALTH SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:N
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:434-791-2059
Mailing Address - Street 1:108 HOLBROOK ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1758
Mailing Address - Country:US
Mailing Address - Phone:434-791-2059
Mailing Address - Fax:434-791-2835
Practice Address - Street 1:108 HOLBROOK ST
Practice Address - Street 2:SUITE 203
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1758
Practice Address - Country:US
Practice Address - Phone:434-791-2059
Practice Address - Fax:434-791-2835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC02811Medicare PIN