Provider Demographics
NPI:1851485718
Name:BEHAVIORAL HEALTH ASSOCIATES LTC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH ASSOCIATES LTC
Other - Org Name:COMPREHENSIVE MENTAL HEALTH ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:NOGUES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:757-361-6634
Mailing Address - Street 1:2010 OLD GREENBRIER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2619
Mailing Address - Country:US
Mailing Address - Phone:757-361-6634
Mailing Address - Fax:757-361-6635
Practice Address - Street 1:2010 OLD GREENBRIER RD
Practice Address - Street 2:SUITE B
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2619
Practice Address - Country:US
Practice Address - Phone:757-361-6634
Practice Address - Fax:757-361-6635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09288Medicare ID - Type UnspecifiedPROVIDER NUMBER