Provider Demographics
NPI:1336220938
Name:THERAPY ASSOCIATES OF DENBIGH, INC
Entity Type:Organization
Organization Name:THERAPY ASSOCIATES OF DENBIGH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETTIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-874-1676
Mailing Address - Street 1:12725 MCMANUS BLVD
Mailing Address - Street 2:BLDG 2 SUITE G
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-4402
Mailing Address - Country:US
Mailing Address - Phone:757-874-1676
Mailing Address - Fax:757-874-2226
Practice Address - Street 1:12725 MCMANUS BLVD
Practice Address - Street 2:BLDG 2 SUITE G
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4402
Practice Address - Country:US
Practice Address - Phone:757-874-1676
Practice Address - Fax:757-874-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1336220938Medicaid
VA1336220938Medicaid