Provider Demographics
NPI:1265112825
Name:DREW, CHRISTOPHER BERNARD JR (PC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BERNARD
Last Name:DREW
Suffix:JR
Gender:M
Credentials:PC
Other - Prefix:MRS
Other - First Name:AKEEYA
Other - Middle Name:ALEXIS
Other - Last Name:DREW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHP
Mailing Address - Street 1:1307 RIVER WALK TER APT 302
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-6189
Mailing Address - Country:US
Mailing Address - Phone:757-696-3116
Mailing Address - Fax:804-735-0355
Practice Address - Street 1:1307 RIVER WALK TER APT 302
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-6189
Practice Address - Country:US
Practice Address - Phone:757-696-3116
Practice Address - Fax:804-735-0355
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0732000800101Y00000X, 101YM0800X
VA0733000792101YM0800X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician