Provider Demographics
NPI:1669546875
Name:MENTAL HEALTH AMERICA OF CENTRAL VIRGINIA
Entity type:Organization
Organization Name:MENTAL HEALTH AMERICA OF CENTRAL VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:434-316-9339
Mailing Address - Street 1:2316 ATHERHOLT RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2100
Mailing Address - Country:US
Mailing Address - Phone:434-316-9339
Mailing Address - Fax:434-316-7025
Practice Address - Street 1:2316 ATHERHOLT RD
Practice Address - Street 2:SUITE 206
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2100
Practice Address - Country:US
Practice Address - Phone:434-316-9339
Practice Address - Fax:434-316-7025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002466101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005413222Medicaid