Provider Demographics
NPI:1669846713
Name:ESIRI, INC
Entity Type:Organization
Organization Name:ESIRI, INC
Other - Org Name:ESIRI MINISTRIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHEVETTE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, NCC, LPC
Authorized Official - Phone:757-575-0811
Mailing Address - Street 1:5900 E VIRGINIA BEACH BLVD
Mailing Address - Street 2:EXECUTIVE BUILDING SUITE 104
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2530
Mailing Address - Country:US
Mailing Address - Phone:757-575-0811
Mailing Address - Fax:855-450-0830
Practice Address - Street 1:5900 E VIRGINIA BEACH BLVD
Practice Address - Street 2:SUITE104
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2530
Practice Address - Country:US
Practice Address - Phone:757-575-0811
Practice Address - Fax:855-450-0830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-29
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1043331739OtherNPI