Commonwealth Behavioral Health, Inc.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701004809 Issued in VA

Legal business name

COMMONWEALTH BEHAVIORAL HEALTH, INC.

Practice address

13356 Midlothian Tpke
Suite 202
Midlothian, VA 23113-4210

Phone

(804) 721-1720

Fax

(804) 214-2177

NPI assigned

Dec 4, 2011

Last updated

Dec 4, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Pascal Thebaud

Title

Director

Phone

(804) 721-1720

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322956800000",
    "number": "1003184144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73702",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232358045",
            "telephone_number": "804-721-1720",
            "fax_number": "804-214-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13356 MIDLOTHIAN TPKE",
            "address_2": "SUITE 202",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231134210",
            "telephone_number": "804-721-1720",
            "fax_number": "804-214-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-04",
        "last_updated": "2011-12-04",
        "status": "A",
        "authorized_official_last_name": "THEBAUD",
        "authorized_official_first_name": "PASCAL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "804-721-1720"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.