Provider Demographics
NPI:1417582800
Name:COMPREHENSIVE CLINICAL & PROFESSIONAL SERVICES, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE CLINICAL & PROFESSIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAWNDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:UMBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:MA NCC CCMHC
Authorized Official - Phone:757-788-1450
Mailing Address - Street 1:213 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1133
Mailing Address - Country:US
Mailing Address - Phone:757-788-1450
Mailing Address - Fax:757-257-4143
Practice Address - Street 1:213 WEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-1133
Practice Address - Country:US
Practice Address - Phone:757-788-1450
Practice Address - Fax:757-210-6571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-06
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health