Provider Demographics
NPI:1881033074
Name:PSYCHIATRIC CONSULTANTS OF HAMPTON ROADS
Entity Type:Organization
Organization Name:PSYCHIATRIC CONSULTANTS OF HAMPTON ROADS
Other - Org Name:PEGASUS PSYCHIATRIC AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN,PHD,FNP-BC
Authorized Official - Phone:757-468-0550
Mailing Address - Street 1:4854 HAYGOOD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-5351
Mailing Address - Country:US
Mailing Address - Phone:757-468-0550
Mailing Address - Fax:
Practice Address - Street 1:4854 HAYGOOD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-5351
Practice Address - Country:US
Practice Address - Phone:757-468-0550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty