Provider Demographics
NPI:1932291291
Name:NORFOLK PSYCHIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:NORFOLK PSYCHIATRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:TANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-461-3313
Mailing Address - Street 1:6330 NEWTOWN RD STE 625
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4808
Mailing Address - Country:US
Mailing Address - Phone:757-461-3313
Mailing Address - Fax:757-461-8363
Practice Address - Street 1:6330 NEWTOWN RD STE 625
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4808
Practice Address - Country:US
Practice Address - Phone:757-461-3313
Practice Address - Fax:757-461-8363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB59753Medicare UPIN
VAA54965Medicare UPIN
VAB09681Medicare UPIN
VAR58628Medicare UPIN
VAB62680Medicare UPIN
VAB07356Medicare UPIN
VA009739N21Medicare ID - Type Unspecified