NPIMap

Organization Active NPI

Phoenix Mental Health LLC

  • Point of Service
  • Virginia Beach, VA
National Provider Identifier
1437590601
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
0701003229 Issued in VA
Legal business name
PHOENIX MENTAL HEALTH LLC
Practice address
100 S Boggs Ave
Virginia Beach, VA 23452-1705
Phone
(757) 453-4017
NPI assigned
Jul 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Authorized official

Name
Dr. Richard M Mason Jr., PHD, LPC, ACS
Title
LPC
Phone
(757) 453-4017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 0701003229 VA Primary

Addresses

Primary practice location

100 S Boggs Ave
Virginia Beach, VA 23452-1705

Mailing address

810 Kempsville Rd Ste 6
Virginia Beach, VA 23464-2723
Phone (757) 453-4017

Other identifiers 1

IdentifierTypeStateIssuer
1891042438OtherVANPI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1437590601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 KEMPSVILLE RD STE 6",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234642723",
            "telephone_number": "757-453-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S BOGGS AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521705",
            "telephone_number": "757-453-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-16",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LPC",
        "authorized_official_telephone_number": "757-453-4017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHD, LPC, ACS"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "VA",
            "license": "0701003229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1891042438",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; 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.