Provider Demographics
NPI:1407212079
Name:AFI OUTPATIENT MENTAL HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:AFI OUTPATIENT MENTAL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERIE
Authorized Official - Middle Name:REGINA
Authorized Official - Last Name:SIMS MAWUSI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:757-315-8039
Mailing Address - Street 1:3217 COMMANDER SHEPARD BLVD.
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666
Mailing Address - Country:US
Mailing Address - Phone:757-315-8039
Mailing Address - Fax:757-224-2055
Practice Address - Street 1:3217 COMMANDER SHEPARD BLVD.
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-1598
Practice Address - Country:US
Practice Address - Phone:757-315-8039
Practice Address - Fax:757-224-2055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040049041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty