Provider Demographics
NPI:1285686543
Name:NEUROPSYCHIATRIC & COUNSELING
Entity Type:Organization
Organization Name:NEUROPSYCHIATRIC & COUNSELING
Other - Org Name:NEUROPSYCHIATRIC AND CONSELING ASSOC.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIANO
Authorized Official - Middle Name:M
Authorized Official - Last Name:PIEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-282-5236
Mailing Address - Street 1:9020 STONY POINT PKWY
Mailing Address - Street 2:STE 240
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1947
Mailing Address - Country:US
Mailing Address - Phone:804-282-5236
Mailing Address - Fax:804-282-5547
Practice Address - Street 1:9020 STONY POINT PKWY
Practice Address - Street 2:STE 240
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1947
Practice Address - Country:US
Practice Address - Phone:804-282-5236
Practice Address - Fax:804-282-5547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA000408OtherVALUE OPTIONS
VA35720OtherMDIPA
VA087637OtherSENTARA
VA007172109Medicaid
VA007172109Medicaid
VA1C03130Medicare PIN