Petitecha Wimbush, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024181676 Issued in VA

Practice address

13000 Rivers Bend Blvd
Chester, VA 23836-8632

Phone

(804) 234-4893

NPI assigned

Jul 23, 2021

Last updated

Jun 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Modern Integrative Psychiatry, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chester, VA
  • NPI 1972387892
  NPD Authorized official
• Resilience Counseling & Social Skills Center LLC

  dba Resilience Counseling & Social Skills Center

  • Professional Counselor
  • Midlothian, VA
  • NPI 1245724707

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1285207522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 RIVERS BEND BLVD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238368632",
            "telephone_number": "804-234-4893",
            "fax_number": "804-964-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 RIVERS BEND BLVD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238368632",
            "telephone_number": "804-234-4893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMBUSH",
        "first_name": "PETITECHA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024181676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roxanne Williams, PT, DPT
• Tara Williams
• Terry Williams
• Dana Wilson
• Steven Gerard Wilson, PT
• Christina Michelle Winfrey
• Pippi M. Wingfield, MSW., LCSW
• Asia Ariel Winningham, HIS
• Savion Winston
• Fielder Wise

• Psychiatric/Mental Health Nurse Practitioner in Chester, VA
• Providers in Chester, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.