| Virginia South Psychiatric & Family Services | |
|
269 Medical Park Blvd Petersburg VA 23805 | |
| (804) 861-0700 | |
| (804) 863-4626 |
| Full Name | Virginia South Psychiatric & Family Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 269 Medical Park Blvd, Petersburg, Virginia |
| Authorized Official Name and Position | Anthony Joseph Vadella (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 8045186504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia South Psychiatric & Family Services 269 Medical Park Blvd Petersburg VA 23805 Ph: (804) 518-6504 | Virginia South Psychiatric & Family Services 269 Medical Park Blvd Petersburg VA 23805 Ph: (804) 861-0700 |
| NPI Number | 1700894466 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 09/12/2022 |
| Certification Date | 09/12/2022 |
| Medicare PECOS PAC ID | 3476443797 |
|---|---|
| Medicare Enrollment ID | O20040318001272 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700894466 | NPI | - | NPPES |
| 010325994 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Salman Siddiqui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437110053 PECOS PAC ID: 4587568217 Enrollment ID: I20040209001180 |
| Provider Name | Padmaja Chaparala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366556334 PECOS PAC ID: 0042294860 Enrollment ID: I20040617000733 |
| Provider Name | Thresa Simon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003871989 PECOS PAC ID: 2264496827 Enrollment ID: I20041115000583 |
| Provider Name | Kelly J Britt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922166420 PECOS PAC ID: 7719917939 Enrollment ID: I20050817000858 |
| Provider Name | Thomas A Crooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700826062 PECOS PAC ID: 9335151984 Enrollment ID: I20060622000182 |
| Provider Name | Banerje Koduru |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285644104 PECOS PAC ID: 3375547201 Enrollment ID: I20060908000087 |
| Provider Name | Edmund W Creekmore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861441511 PECOS PAC ID: 9830285832 Enrollment ID: I20071023000165 |
| Provider Name | Ramesh B Koduri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609831544 PECOS PAC ID: 4981604584 Enrollment ID: I20080617000286 |
| Provider Name | Devi Vasu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114121829 PECOS PAC ID: 0749326635 Enrollment ID: I20091007000080 |
| Provider Name | Akm Sulaman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851500516 PECOS PAC ID: 0547309130 Enrollment ID: I20091119000580 |
| Provider Name | Charles E Hodges |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093891467 PECOS PAC ID: 8628117702 Enrollment ID: I20091202000673 |
| Provider Name | Chandramouleswar R Amara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942265509 PECOS PAC ID: 0446250542 Enrollment ID: I20100407000438 |
| Provider Name | Walid Fawaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477714111 PECOS PAC ID: 3274658646 Enrollment ID: I20100909000493 |
| Provider Name | Rakesh Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942419692 PECOS PAC ID: 5294911137 Enrollment ID: I20110511000075 |
| Provider Name | Edward G Canada |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174680466 PECOS PAC ID: 9931385150 Enrollment ID: I20110523000711 |
| Provider Name | Sarah W Darling |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508010034 PECOS PAC ID: 0143407312 Enrollment ID: I20110615000883 |
| Provider Name | Christina D Dhir |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295052587 PECOS PAC ID: 7315115672 Enrollment ID: I20110713000146 |
| Provider Name | Amy Carter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760440952 PECOS PAC ID: 7618140682 Enrollment ID: I20111108000371 |
| Provider Name | Krista M Pine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215030549 PECOS PAC ID: 3971505587 Enrollment ID: I20111118000192 |
| Provider Name | Victor Spencer Ferguson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316270283 PECOS PAC ID: 8628229838 Enrollment ID: I20121116000533 |
| Provider Name | Ashley Foresman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245675958 PECOS PAC ID: 2961632914 Enrollment ID: I20140313000891 |
| Provider Name | Jagdeep K Kahlon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669633319 PECOS PAC ID: 1658528427 Enrollment ID: I20140514001873 |
| Provider Name | David Nathaniel Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710110655 PECOS PAC ID: 4688609290 Enrollment ID: I20150225000405 |
| Provider Name | Haluk K Aydin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700857836 PECOS PAC ID: 7618012261 Enrollment ID: I20151201002393 |
| Provider Name | Prakash Bhushan Karn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245487503 PECOS PAC ID: 8224339825 Enrollment ID: I20151228001243 |
| Provider Name | Sunny Hong |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700234622 PECOS PAC ID: 0749574465 Enrollment ID: I20160803001512 |
| Provider Name | Neil N Hines |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083798227 PECOS PAC ID: 9638464480 Enrollment ID: I20160818001744 |
| Provider Name | Jennifer V Ralsten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699123745 PECOS PAC ID: 6901194919 Enrollment ID: I20161006001729 |
| Provider Name | Harpreet Reeba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104268796 PECOS PAC ID: 2365730041 Enrollment ID: I20161012001774 |
| Provider Name | Barbara Hartmann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174797906 PECOS PAC ID: 8426327156 Enrollment ID: I20170711003483 |
| Provider Name | Srinivasa R Punyala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891134599 PECOS PAC ID: 1052553690 Enrollment ID: I20170728003278 |
| Provider Name | Jessica L Beach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518256940 PECOS PAC ID: 6103002928 Enrollment ID: I20180813000204 |
| Provider Name | Aslihan Sogutlu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306244215 PECOS PAC ID: 7911293790 Enrollment ID: I20180823000071 |
| Provider Name | Louis Lazzara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558786186 PECOS PAC ID: 3870925381 Enrollment ID: I20191120002951 |
| Provider Name | Amanda M Snow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639640063 PECOS PAC ID: 7719310168 Enrollment ID: I20191126000765 |
| Provider Name | Andrew Orr |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598025033 PECOS PAC ID: 9335449511 Enrollment ID: I20200527002492 |
| Provider Name | Muhammad H Abbas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871944462 PECOS PAC ID: 9234550872 Enrollment ID: I20200605001923 |
| Provider Name | Olivia T Mendoza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104452010 PECOS PAC ID: 9436572468 Enrollment ID: I20200709002681 |
| Provider Name | Lisa A Castro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316270416 PECOS PAC ID: 9436576931 Enrollment ID: I20200828002070 |
| Provider Name | Germaine Kelley-pope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235749714 PECOS PAC ID: 5092127365 Enrollment ID: I20201211002186 |
| Provider Name | Renee Michele Green |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457930976 PECOS PAC ID: 2163822263 Enrollment ID: I20210610003013 |
| Provider Name | Robin L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144808833 PECOS PAC ID: 9032512868 Enrollment ID: I20210730001086 |
| Provider Name | Hailegiorgis T Bizuneh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417528225 PECOS PAC ID: 9436555968 Enrollment ID: I20210909000989 |
| Provider Name | Shela Aquan West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093480238 PECOS PAC ID: 4880082346 Enrollment ID: I20211102002925 |
| Provider Name | Theresa Rose Searls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154564003 PECOS PAC ID: 3779722616 Enrollment ID: I20220202002895 |
| Provider Name | Cameron Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306509633 PECOS PAC ID: 2466848239 Enrollment ID: I20220404000911 |
| Provider Name | Manjit Sangha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447661871 PECOS PAC ID: 7214304500 Enrollment ID: I20221028001825 |
| Provider Name | Golda Victoria Navarro Trompeta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043927387 PECOS PAC ID: 9931570884 Enrollment ID: I20230201000232 |
| Provider Name | Bandhan Chakraborty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629416631 PECOS PAC ID: 5395986780 Enrollment ID: I20230215000814 |
| Provider Name | Donna L Benjamin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811289226 PECOS PAC ID: 6800065483 Enrollment ID: I20230607003161 |
| Provider Name | Mohammad Imtiaz Mubbashar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619497823 PECOS PAC ID: 7911368154 Enrollment ID: I20230803001931 |
| Provider Name | Kenneth Arehart |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508822727 PECOS PAC ID: 0042656373 Enrollment ID: I20240308003357 |
| Provider Name | Nicole K Beer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407939184 PECOS PAC ID: 1951589423 Enrollment ID: I20240319001149 |
Commonwealth Day Support Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 S Sycamore St, Petersburg, VA 23803 Phone: 804-908-4635 | |
Family Resolution Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2825 S Crater Rd, #4, Petersburg, VA 23805 Phone: 804-861-3540 Fax: 804-861-3541 | |
Spring Of Hope Therapeutic Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 Brown St Ste 117, Petersburg, VA 23803 Phone: 804-721-0354 | |
Family Preservation Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1450 Talley Ave, Petersburg, VA 23803 Phone: 804-231-1350 | |
Rizing Starz,llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 31c South Jefferson St, Petersburg, VA 23803 Phone: 804-926-5268 | |
Therapeutic In Home Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1949 Vesonder Rd, Petersburg, VA 23805 Phone: 804-640-2101 Fax: 877-879-6336 | |
Agape Angels Resoultion Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1430 Farmer St, Petersburg, VA 23803 Phone: 804-919-0364 |