DISTRICT 19 COMMUNITY SERVICES BOARD


Address: 20 W Bank St, Suite 2, Petersburg, VA 23803-3279
Phone: 8048628054

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
VA 4945280 05

Other Provider/Organization Names

Other Name Type Code
District 19 Mental Health and Mental Retardation Services Former Legal Business Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 20 W BANK ST
SUITE 2
City PETERSBURG
State VA
Zip Code 23803-3279

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Competitor

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City PETERSBURG
Zip Code 23803

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Dataset Information

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.

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