Provider Demographics
NPI:1669362570
Name:DRBACW INC
Entity type:Organization
Organization Name:DRBACW INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:C
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD MS
Authorized Official - Phone:757-941-8182
Mailing Address - Street 1:1309 JAMESTOWN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-3380
Mailing Address - Country:US
Mailing Address - Phone:757-941-8182
Mailing Address - Fax:757-500-0134
Practice Address - Street 1:1309 JAMESTOWN RD STE 201
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3380
Practice Address - Country:US
Practice Address - Phone:757-941-8182
Practice Address - Fax:757-500-0134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty