NPIMap

Organization Active NPI

Dominion Behavioral Healthcare of Chesterfield

  • Clinical Psychologist
  • North Chesterfield, VA
National Provider Identifier
1831592898
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DOMINION BEHAVIORAL HEALTHCARE OF CHESTERFIELD
Practice address
703 N Courthouse Rd
Suite 101
North Chesterfield, VA 23236-4069
Phone
(804) 794-4482
Fax
(804) 379-7578
NPI assigned
Oct 6, 2014
Last updated
Oct 6, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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

Authorized official

Name
Dr. Robert Samuel Falk, PHDNPI 1730133554
Title
Vice President
Phone
(804) 794-4482

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

703 N Courthouse Rd
Suite 101
North Chesterfield, VA 23236-4069

Mailing address

703 N Courthouse Rd
Suite 101
North Chesterfield, VA 23236-4069
Phone (804) 794-4482

National Provider Directory

National Provider Directory

Locations

703 N Courthouse Rd
Ste 101
North Chesterfield, VA 23236
Phone (804) 794-4482

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": "1412553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412553600000",
    "number": "1831592898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 N COURTHOUSE RD",
            "address_2": "SUITE 101",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232364069",
            "telephone_number": "804-794-4482",
            "fax_number": "804-379-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N COURTHOUSE RD",
            "address_2": "SUITE 101",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232364069",
            "telephone_number": "804-794-4482",
            "fax_number": "804-379-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINION BEHAVIORAL HEALTHCARE OF CHESTERFIELD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-06",
        "last_updated": "2014-10-06",
        "status": "A",
        "authorized_official_last_name": "FALK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "804-794-4482",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; 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.