Provider Demographics
NPI:1578861118
Name:YWCA OF SOUTH HAMPTON ROADS
Entity Type:Organization
Organization Name:YWCA OF SOUTH HAMPTON ROADS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-625-4248
Mailing Address - Street 1:500 E PLUME ST STE 700
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-2311
Mailing Address - Country:US
Mailing Address - Phone:757-625-4248
Mailing Address - Fax:
Practice Address - Street 1:500 E PLUME ST STE 700
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2311
Practice Address - Country:US
Practice Address - Phone:757-625-4248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health