Divine Pathways Support Services LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

DIVINE PATHWAYS SUPPORT SERVICES LLC

Practice address

917 Winding Trail LN
Richmond, VA 23223-2289

Phone

(804) 389-3201

NPI assigned

Jun 30, 2023

Last updated

Jun 30, 2023By 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

Shawanda Chantelle Cheatham

Title

Owner

Phone

(804) 389-3201

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1417634478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 WINDING TRAIL LN",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232232289",
            "telephone_number": "804-389-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 WINDING TRAIL LN",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232232289",
            "telephone_number": "804-389-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PATHWAYS SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "CHEATHAM",
        "authorized_official_first_name": "SHAWANDA",
        "authorized_official_middle_name": "CHANTELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-389-3201"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diversity Residential Homes
• Diversity Training & Support Center
• Divine Kings & Queens
• Divine Mind Therapeutics LLC
• Divine Minds Youth Services
• Divine Residential Services, LLC
• Divine Residential Services, LLC. (Divine Transformation)
• Thomas James Dix, DDS
• Neel Dixit, MD
• Alia Renee Dixon, FNP-BC

• Adolescent and Children Mental Health Clinic/Center in Richmond, VA
• Providers in Richmond, VA by specialty
• Adolescent and Children Mental Health Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.