JUSTIN MANGOLD (NPI# 1679056535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679056535 |
| Entity Type | Individual |
| Full Name | JUSTIN MANGOLD |
| Practice Address |
5477 Mooretown Rd Williamsburg VA 23188-2108 |
| Practice Telephone | 7575650106 |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2018-09-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
0701003834 | VA | Behavioral Health & Social Service Providers |
| Street Address |
5477 MOORETOWN RD |
| City | WILLIAMSBURG |
| State | VA |
| Zip Code | 23188-2108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215030549 | Krista Pine | Psychiatry & Neurology | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2006-09-05 |
| 1073082962 | Rebecca J Cornell | Counselor | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2018-11-20 |
| 1164905709 | Gary Lee Baker | Counselor | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2018-09-10 |
| 1336621226 | Cynthia Betts | Social Worker | 5477 Mooretown Rd, Williamsburg, VA 23188 | 2018-09-06 |
| 1629576590 | Stephen Lynn Simmers | Counselor | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2018-01-25 |
| 1821503160 | Andreas Bienert | Counselor | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2017-12-08 |
| 1033544606 | Odessa Ochoa | Physician Assistant | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2013-09-13 |
| 1164703401 | Susan N Walkley | Nurse Practitioner | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2011-08-31 |
| 1861714404 | Van Aiken Deblieux | Counselor | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2010-02-24 |
| 1740450055 | Penelope Proctor Ziegler | Psychiatry & Neurology | 5477 Mooretown Rd, Williamsburg, VA 23188-2108 | 2008-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992287833 | Kathryn Goss Atanasov | Counselor | Farley Iop Williamsburg Place, 5477 Mooretown Road, Williamsburg, VA 23188 | 2018-09-06 |
| 1386180933 | Brittany Marie Purdy | Physical Therapist | 6425 Richmond Road, Williamsburg, VA 23188 | 2017-01-06 |
| 1770930745 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 6485 Centerville Rd, Williamsburg, VA 23188 | 2016-05-19 |
| 1073979738 | Sharon Harper | Social Worker | 4732 Longhill Road, Suite 3202, Williamsburg, VA 23188 | 2016-01-12 |
| 1710362819 | Diamond Healthcare | Social Worker | 5477 Mooretown Road, Williamsburg Place, Williamsburg, VA 23188 | 2015-07-30 |
| 1922489749 | Uc Davis Medical Center | General Acute Care Hospital | 3905 Cold Spring Rd, Williamsburg, VA 23188 | 2015-06-17 |
| 1013326214 | Deandra Smith | Developmental Therapist | 111 Bulifants Blvd Ste B, Williamsburg, VA 23188 | 2014-08-13 |
| 1255751590 | Lisa Marie Frazier | Counselor | 4345 New Town Ave. Ste. 107a, Williamsburg, VA 23188 | 2014-04-25 |
| 1972883569 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 7529 Richmond Rd, Williamsburg, VA 23188 | 2011-08-26 |
| 1720386816 | Harry Leon White | Pharmacist | 114 Molesey Hurst, Williamsburg, VA 23188 | 2011-03-14 |
| Find all providers in zip 23188 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295353142 | Glenn Paul Clavet | Counselor | 4044 Penzance Pl, Williamsburg, VA 23188-6641 | 2020-07-08 |
| 1942831300 | Stephanie Jo Ellison | Counselor | 5000 New Point Rd, Williamsburg, VA 23188-9411 | 2020-02-03 |
| 1215580675 | Sarah Patricia Cloud | Counselor | 76 Wilson Rd, Williamsburg, KY 40769-9308 | 2019-07-24 |
| 1023572674 | Blair Elder Farrar | Counselor | 372 Mclaws Cir Ste 2, Williamsburg, VA 23185-5636 | 2019-01-29 |
| 1851855688 | Rachel Cunningham | Counselor | 1657 Merrimac Trl Bldg 1, Williamsburg, VA 23185-5624 | 2019-01-25 |
| 1720554090 | Sarah Elizabeth Clayton | Counselor | 5388 Discovery Park Blvd Ste 120b, Williamsburg, VA 23188-8218 | 2018-10-15 |
| 1669919833 | Ian Demodna | Counselor | 1001 Richmond Rd, Williamsburg, VA 23185-2895 | 2017-01-26 |
| 1275081598 | Joelle Janice Griffin Russell | Counselor | 1651 Merrimac Trl, Williamsburg, VA 23185-5624 | 2016-09-15 |
| 1326407610 | Karen Lynn Mapp Hall | Counselor | 907 Richmond Rd, Williamsburg, VA 23185-2821 | 2016-02-16 |
| 1992192702 | Donna Haygood Jackson | Counselor | 209 Yorkshire Dr, Williamsburg, VA 23185-3912 | 2015-04-20 |
| Find all providers in WILLIAMSBURG | ||||
| City | WILLIAMSBURG |
| Zip Code | 23188 |
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| 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.