District 19 Community Services Board
Organization Active NPI Early Intervention Provider Agency · Petersburg, VA
NPI 1669970646 · NPPES record last updated Jan 25, 2018
Key facts
- NPI
- 1669970646
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Early Intervention Provider Agency 252Y00000X
- License
- 184 (VA)
- Legal business name
- DISTRICT 19 COMMUNITY SERVICES BOARD
- Practice address
- 20 W Bank St Ste 5
Petersburg, VA 23803-3279 - Phone
- (804) 862-6082
- Fax
- (804) 862-6158
- NPI assigned
- Jan 25, 2018
- Organization subpart
- No
Authorized official
- Name
- Mrs. Lisa A Newby
- Title
- Executive Assistant
- Phone
- (804) 862-6082
Corporate family (same tax ID) 1
Practitioners 5
-
Lauren Grizzard Allen, LCSW
-
Rachel R. Gillus, LPC
-
Amaresh B Khandat, M.D.
-
Barbara Michelle Vazquez, LCSW
-
Dawn Webb Welch, MSW, LCSW
National Provider Directory
- Tax ID family
- District 19 Community Services Board
Locations
20 W Bank St
Ste 5
Petersburg, VA 23803
Phone (804) 863-1689
20 W Bank St
Ste 7
Petersburg, VA 23803
Phone (804) 862-8054
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | 184 | VA | Yes |
Addresses
Primary practice location
20 W Bank St Ste 5
Petersburg, VA 23803-3279
Mailing address
20 W Bank St Ste 7
Petersburg, VA 23803-3279
Phone (804) 862-6082
Other providers in Petersburg, VA
- Laura E. Diaz
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- Dinwiddie Health Care LLC
- Direct Anesthesia Partners LLC
- District 19 Community Services Board
- Divine Medical Services
- Christine L. Dobosz
- Doctor Hugh C Dowdy III DDS PLLC
- Dogwood Emergency Physicians
- Dominion Cardiology PC
All providers in Petersburg, VA · Early Intervention Provider Agency in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.