Active NPI
Heroic Mental Health LLC
- Psychiatric/Mental Health Nurse Practitioner
- Suffolk, VA
National Provider Identifier
1629721980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- HEROIC MENTAL HEALTH LLC
- Practice address
- 425 W Washington St Ste 4
Suffolk, VA 23434-5320 - Phone
- (757) 737-3134
- NPI assigned
- Jan 27, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chika Ogbolu, NP
- Title
- Owner/Provider
- Phone
- (757) 737-3134
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
425 W Washington St Ste 4
Suffolk, VA 23434-5320
Mailing address
425 W Washington St Ste 4
Suffolk, VA 23434-5320
Phone (757) 737-3134
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643241600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1643241600000",
"number": "1629721980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 W WASHINGTON ST STE 4",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234345320",
"telephone_number": "757-737-3134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 W WASHINGTON ST STE 4",
"city": "SUFFOLK",
"state": "VA",
"postal_code": "234345320",
"telephone_number": "757-737-3134"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEROIC MENTAL HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-01-27",
"last_updated": "2022-01-27",
"certification_date": "2022-01-27",
"status": "A",
"authorized_official_last_name": "OGBOLU",
"authorized_official_first_name": "CHIKA",
"authorized_official_title_or_position": "OWNER/PROVIDER",
"authorized_official_telephone_number": "757-737-3134",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Suffolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.