Provider Demographics
NPI:1790347110
Name:PARTNERS IN WOMEN'S MENTAL HEALTH
Entity Type:Organization
Organization Name:PARTNERS IN WOMEN'S MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MARY FUSS
Authorized Official - Last Name:REALI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:757-285-1080
Mailing Address - Street 1:819 W 21ST ST # 101
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-1539
Mailing Address - Country:US
Mailing Address - Phone:757-828-3816
Mailing Address - Fax:
Practice Address - Street 1:819 W 21ST ST # 101
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-1539
Practice Address - Country:US
Practice Address - Phone:757-828-3816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty