Organization Active NPI

Heroic Mental Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Suffolk, VA
National Provider Identifier
1629721980
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
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

Updated by the provider on Jan 27, 2022

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

Authorized official

Name
Chika Ogbolu, NPNPI 1528549219
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)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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 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.

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.

Verify at the official NPI Registry.