Provider Demographics
NPI:1780740811
Name:TRANSPERSONAL HEALING CONCEPTS
Entity type:Organization
Organization Name:TRANSPERSONAL HEALING CONCEPTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARISSE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKSDALE
Authorized Official - Suffix:
Authorized Official - Credentials:DSC DNM
Authorized Official - Phone:757-216-8097
Mailing Address - Street 1:485 S INDEPENDENCE BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1129
Mailing Address - Country:US
Mailing Address - Phone:757-216-8097
Mailing Address - Fax:757-216-8101
Practice Address - Street 1:485 S INDEPENDENCE BLVD STE 111
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1129
Practice Address - Country:US
Practice Address - Phone:757-216-8097
Practice Address - Fax:757-216-8097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-01
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2006210163R302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization