Provider Demographics
NPI:1750450441
Name:OVERSTREET, BELINDA
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:
Last Name:OVERSTREET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9702 GAYTON RD
Mailing Address - Street 2:#181
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-4907
Mailing Address - Country:US
Mailing Address - Phone:804-741-7500
Mailing Address - Fax:804-741-7500
Practice Address - Street 1:9702 GAYTON RD
Practice Address - Street 2:#181
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-4907
Practice Address - Country:US
Practice Address - Phone:804-741-7500
Practice Address - Fax:804-741-7500
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002205103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007712561Medicaid
VA175848OtherANTHEM
VA175848OtherANTHEM