DISTRICT 19 COMMUNITY SERVICES BOARD (NPI# 1225094451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225094451 |
Entity Type | Organization |
Organization Name | DISTRICT 19 COMMUNITY SERVICES BOARD |
Other Organization Name | DISTRICT 19 MENTAL HEALTH AND MENTAL RETARDATION SERVICES |
Practice Address |
20 W Bank St Suite 2 Petersburg VA 23803-3279 |
Practice Telephone | 8048628054 |
Practice Fax Number | 8048631665 |
Mailing Telephone | 8048628054 |
Mailing Fax Number | 8048631665 |
Enumeration Date | 2006-04-25 |
Last Update Date | 2009-07-30 |
Authorized Official Name | MR. JOSEPH E. HUBBARD (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 8048628054 |
Authorized Official Credential | C.P.A. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 252Y00000X | Early Intervention Provider Agency | Agencies | ||
N | 251B00000X | Case Management | Agencies | ||
Y | 251S00000X | Community/Behavioral Health | Agencies |
State | Issuer | Identifier | Type Code |
---|---|---|---|
VA | 4945280 | 05 |
Other Name | Type Code |
---|---|
District 19 Mental Health and Mental Retardation Services | Former Legal Business Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669791984 | District 19 Community Services Board | Nursing Care | 502 Sadler Dr, Emporia, VA 23847 | 2010-05-26 |
1679510226 | District 19 Community Services Board | Public Health or Welfare | 5012 Selwood Rd, Richmond, VA 23234-4246 | 2006-06-01 |
1669970646 | District 19 Community Services Board | Early Intervention Provider Agency | 20 W Bank St Ste 5, Petersburg, VA 23803-3279 | 2018-01-25 |
1790113280 | District 19 Community Services Board | Community/Behavioral Health | 232 Coppahaunk Ave, Waverly, VA 23890-5041 | 2013-10-22 |
1194760462 | District 19 Community Services Board | Social Worker | 215 W Atlantic St, Emporia, VA 23847-1223 | 2006-06-19 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | DISTRICT 19 COMMUNITY SERVICES BOARD | 20 West Bank Street Ste 2, Petersburg, VA 23803-3279 |
Street Address |
20 W BANK ST SUITE 2 |
City | PETERSBURG |
State | VA |
Zip Code | 23803-3279 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871190272 | Angel Howard | Social Worker | 20 W Bank St, Petersburg, VA 23803-3279 | 2020-10-08 |
1174135461 | Samuel J Northington Jr. | Counselor | 20 W Bank St, Petersburg, VA 23803-3279 | 2020-08-19 |
1346868767 | Jasmine Griffin | Counselor | 20 W Bank St, Petersburg, VA 23803-3279 | 2020-07-13 |
1104486042 | Samaria M Lewis | Counselor | 20 W Bank St, Petersburg, VA 23803-3279 | 2019-06-13 |
1730658154 | Deatrice Delk | Counselor | 20 W Bank St, Petersburg, VA 23803-3279 | 2018-11-14 |
1770059271 | Andrei Rodin | Counselor | 20 W Bank St, Petersburg, VA 23803-3279 | 2018-10-23 |
1174008619 | Ronald Smith Jr. | Counselor | 20 W Bank St, Petersburg, VA 23803-3279 | 2018-10-01 |
1619471448 | Torri Latrice White | Counselor | 20 W Bank St, Petersburg, VA 23803-3279 | 2018-03-19 |
1780184358 | Ronda Lynn Tate | Counselor | 20 W Bank St, Petersburg, VA 23803-3279 | 2018-02-20 |
1699280503 | Terrelle N Stewart | Counselor | 20 W Bank St, Petersburg, VA 23803-3279 | 2017-12-14 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619523719 | Wise Journey Ltd | Home Health | 325-b Brown Street Suite 132, Petersburg, VA 23803 | 2019-08-14 |
1386101699 | Marliqua Barnes | Driver | 601 Carter St, Petersburg, VA 23803 | 2019-02-22 |
1356596571 | Quality Healthcare Inc | Community/Behavioral Health | 6111 Duncan Rd, Ste F, Petersburg, VA 23803 | 2008-12-02 |
1861614943 | Peoples Family Dental Care | Dentist | 1328 W Washington St, Petersburg, VA 23803 | 2007-05-02 |
1841333721 | Family Preservation Services, Inc | Community/Behavioral Health | 1000 Patterson Ave, Petersburg, VA 23803 | 2007-02-14 |
1154473155 | Progressive Adult Rehabilitation Center, Inc. | Day Training, Developmentally Disabled Services | 114 North Union Street, Suite B, Petersburg, VA 23803 | 2007-01-18 |
1861556615 | Evelyn V. Whitehead | Counselor | 115 E Wythe St, Petersburg, VA 23803 | 2006-12-19 |
1538248778 | Raymond Gibson Smith Jr. | Dentist | Seventh Avenue, Hiram Davis Medical Center, Petersburg, VA 23803 | 2006-11-06 |
1396842282 | Eugene Arthur Richardson IIi | Dentist | 23 Shore Street, Petersburg, VA 23803 | 2006-09-20 |
1679594030 | Olumuyiwa Akinniyi Ojediran | Internal Medicine | 734 South Sycamore Street, Petersburg, VA 23803 | 2006-07-21 |
Find all providers in zip 23803 |
Taxonomy Code | 251S00000X |
Grouping | Agencies |
Classification | Community/Behavioral Health |
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831720713 | Southeast Alaska Regional Health Consortium | Community/Behavioral Health | 202 2nd & Gjoa Street, Petersburg, AK 99833 | 2020-01-30 |
1881104891 | Family Preservation Services, Inc. | Community/Behavioral Health | 816 E Bank St, Petersburg, VA 23803-3406 | 2017-10-04 |
1003342445 | Commonwealth Day Support | Community/Behavioral Health | 500 S Sycamore St, Petersburg, VA 23803-5046 | 2017-05-04 |
1356899652 | Armos | Community/Behavioral Health | 43 Rives Rd Bsmt, Petersburg, VA 23805-9255 | 2016-09-14 |
1427403476 | First Step Service LLC | Community/Behavioral Health | 20 E Tabb St Ste 204, Petersburg, VA 23803-4560 | 2016-04-27 |
1932560927 | Heavenly Touch Counseling Service LLC. | Community/Behavioral Health | 1035 Gustavo Ln, Petersburg, VA 23805-2356 | 2016-03-17 |
1578972139 | Alternative Behavioral Concepts, LLC | Community/Behavioral Health | 441 Harding St, Petersburg, VA 23803-5019 | 2014-08-07 |
1780929364 | Centel Healthcare Inc | Community/Behavioral Health | 803 Hinton St, Suite 308, Petersburg, VA 23803-3028 | 2012-12-07 |
1760789200 | Extreme Counseling Solutions | Community/Behavioral Health | 811 Logan St, Petersburg, VA 23803-3329 | 2011-02-18 |
1861796039 | Envision One | Community/Behavioral Health | 15 Goodrich Ave, Petersburg, VA 23805-2119 | 2011-01-03 |
Find all providers in PETERSBURG |
City | PETERSBURG |
Zip Code | 23803 |
Please comment or provide details below to improve the information on DISTRICT 19 COMMUNITY SERVICES BOARD.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.