NPIMap

Organization Active NPI

Covenant 21St Century Ministries, Inc

Doing business as Covenant Place

  • Mental Illness Community Based Residential Treatment Facility
  • Norfolk, VA
National Provider Identifier
1508036054
Registry record updated Apr 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
80714001 Issued in VA
Legal business name
COVENANT 21ST CENTURY MINISTRIES, INC
Doing business as
Covenant Place
Practice address
260 Filbert St
Norfolk, VA 23505-4410
Phone
(757) 493-2912
Fax
(757) 493-2913
NPI assigned
Mar 11, 2008
Last updated
Apr 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2009

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

Authorized official

Name
Dr. Portia Deneen Rawles, PSY DNPI 1639198153
Title
Clinical Director
Phone
(757) 493-2912

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 80714001 VA Primary

Addresses

Primary practice location

260 Filbert St
Norfolk, VA 23505-4410

Mailing address

5301 Providence Rd
Suite 20
Virginia Beach, VA 23464-4128
Phone (757) 493-2912

Other names 1

  • Covenant Place Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239667200000",
    "number": "1508036054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 PROVIDENCE RD",
            "address_2": "SUITE 20",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644128",
            "telephone_number": "757-493-2912",
            "fax_number": "757-493-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 FILBERT ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054410",
            "telephone_number": "757-493-2912",
            "fax_number": "757-493-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT 21ST CENTURY MINISTRIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2009-04-14",
        "status": "A",
        "authorized_official_last_name": "RAWLES",
        "authorized_official_first_name": "PORTIA",
        "authorized_official_middle_name": "DENEEN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "757-493-2912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "VA",
            "license": "80714001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; 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.