Provider Demographics
NPI:1487867776
Name:CHILD AND FAMILY SERVICES OF EASTERN VIRGINIA
Entity Type:Organization
Organization Name:CHILD AND FAMILY SERVICES OF EASTERN VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:WELP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-622-7017
Mailing Address - Street 1:1805 AIRLINE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3912
Mailing Address - Country:US
Mailing Address - Phone:757-397-2121
Mailing Address - Fax:757-399-3316
Practice Address - Street 1:1805 AIRLINE BLVD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3912
Practice Address - Country:US
Practice Address - Phone:757-397-2121
Practice Address - Fax:757-399-3316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty