| Moody | |
|
816 Independence Blvd Ste 1a Virginia Beach VA 23455-6010 | |
| (757) 955-4073 | |
| Not Available |
| Full Name | Moody |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 816 Independence Blvd Ste 1a, Virginia Beach, Virginia |
| Authorized Official Name and Position | Dyverynce Vaughan (OWNER/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7579554073 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moody 2461 Old Greenbrier Rd Chesapeake VA 23325-4935 Ph: (757) 560-3160 | Moody 816 Independence Blvd Ste 1a Virginia Beach VA 23455-6010 Ph: (757) 955-4073 |
| NPI Number | 1124676564 |
|---|---|
| Provider Enumeration Date | 08/29/2019 |
| Last Update Date | 11/05/2021 |
| Certification Date | 11/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124676564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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