NPIMap

Organization Active NPI

Child & Family Services of Eastern Virginia, Inc

Doing business as The Up Center

  • Community/Behavioral Health Agency
  • Norfolk, VA
National Provider Identifier
1629158159
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHILD & FAMILY SERVICES OF EASTERN VIRGINIA, INC
Doing business as
The Up Center
Practice address
222 W 19TH St
Norfolk, VA 23517-2218
Phone
(757) 622-7017
Fax
(757) 640-8402
NPI assigned
Oct 17, 2006
Last updated
Jan 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Authorized official

Name
Ms. Brenda Luverne Jones
Title
Billing Supervisor
Phone
(757) 622-7017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

222 W 19TH St
Norfolk, VA 23517-2218

Mailing address

222 W 19TH St
Norfolk, VA 23517-2218
Phone (757) 622-7017

Other identifiers 10

IdentifierTypeStateIssuer
1538364179OtherVAMARY A BRANTLEY - PROVIDER
1295888501OtherVAKRISTIN HARDEE-POULIN - PROVIDER
1689689234OtherVAFREDRICK D WESTON - PROVIDER
1285737205OtherVAGLORIA M SAUNDERS - PROVIDER
1417028291OtherVACONSTANTINA KOUZI
1215917315OtherVAJAMES ZELL - PROVIDER
1033273560OtherVAJ. KELLIE EVANS - PROVIDER
1194891598OtherVAANDREA LONG - PROVIDER
1487764825OtherVADEBORAH LEECY - PROVIDER
1487840641OtherVASHAWN WARE-AVANT - PROVIDER

Other names 1

  • The Up Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100715000882 VA Part B Supplier - Clinic/Group Practice 7618009333 Receives reassigned benefits from 16 practitioners
Practice locations: Norfolk, VA; Portsmouth, VA; Suffolk, VA; Virginia Beach, VA

National Provider Directory

National Provider Directory
Tax ID family
Child and Family Services of Eastern Virginia3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

222 W 19th St
Norfolk, VA 23517
Phone (757) 622-7017

580 E Main St
Ste 400
Norfolk, VA 23510

1805 Airline Blvd
Portsmouth, VA 23707
Phone (757) 337-3557

109 Clay St
Suffolk, VA 23434
Phone (757) 539-7971

828 Healthy Way
Ste 105
Virginia Beach, VA 23462
Phone (757) 622-7017

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1629158159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W 19TH ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235172218",
            "telephone_number": "757-622-7017",
            "fax_number": "757-640-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 19TH ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235172218",
            "telephone_number": "757-622-7017",
            "fax_number": "757-640-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD & FAMILY SERVICES OF EASTERN VIRGINIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "LUVERNE",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "757-622-7017",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARY A BRANTLEY - PROVIDER",
            "identifier": "1538364179",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KRISTIN HARDEE-POULIN - PROVIDER",
            "identifier": "1295888501",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREDRICK D WESTON - PROVIDER",
            "identifier": "1689689234",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GLORIA M SAUNDERS - PROVIDER",
            "identifier": "1285737205",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONSTANTINA KOUZI",
            "identifier": "1417028291",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JAMES ZELL - PROVIDER",
            "identifier": "1215917315",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "J. KELLIE EVANS - PROVIDER",
            "identifier": "1033273560",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANDREA LONG - PROVIDER",
            "identifier": "1194891598",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEBORAH LEECY - PROVIDER",
            "identifier": "1487764825",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SHAWN WARE-AVANT - PROVIDER",
            "identifier": "1487840641",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Up Center",
            "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 Jan 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.