Phases Family Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PHASES FAMILY SERVICES

Practice address

27037 Flaggy Run Rd
Courtland, VA 23837-2518

Phone

(757) 376-0149

NPI assigned

Jul 6, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Ethel Williamson Riddick-Mayo, QMHP

Title

Owner

Phone

(757) 376-0149

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1063190361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27037 FLAGGY RUN RD",
            "city": "COURTLAND",
            "state": "VA",
            "postal_code": "238372518",
            "telephone_number": "757-376-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27037 FLAGGY RUN RD",
            "city": "COURTLAND",
            "state": "VA",
            "postal_code": "238372518",
            "telephone_number": "757-376-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHASES FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "RIDDICK-MAYO",
        "authorized_official_first_name": "ETHEL",
        "authorized_official_middle_name": "WILLIAMSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-376-0149",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "QMHP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.