| City Of Chesapeake Ta Chesapeake Community Serv Board | |
|
224 Great Bridge Blvd Chesapeake Comm Services Board Chesapeake VA 23320 | |
| (757) 547-9334 | |
| (757) 819-6292 |
| Full Name | City Of Chesapeake Ta Chesapeake Community Serv Board |
|---|---|
| Speciality | Social Worker |
| Location | 224 Great Bridge Blvd, Chesapeake, Virginia |
| Authorized Official Name and Position | Lisa A Vanlandingham (FISCAL ADMINISTRATOR) |
| Authorized Official Contact | 7575479334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| City Of Chesapeake Ta Chesapeake Community Serv Board Po Box 1647 224 Great Bridge Blvd Chesapeake Comm Services Board Chesapeake VA 23320 Ph: (757) 547-9334 | City Of Chesapeake Ta Chesapeake Community Serv Board 224 Great Bridge Blvd Chesapeake Comm Services Board Chesapeake VA 23320 Ph: (757) 547-9334 |
| NPI Number | 1154496966 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154496966 | NPI | - | NPPES |
| 143683 | Other | VA | TRIGON ANTHEM |
| 083109 | Other | VA | OPTIMA SENTARA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 0701001880 (Virginia) | Primary |
| 104100000X | Social Worker | 0904003047 (Virginia) | Primary |
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