NPIMap

Organization Active NPI

Brookside Psychiatric Specialists PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1841930328
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BROOKSIDE PSYCHIATRIC SPECIALISTS PLLC
Practice address
2624 Southern Blvd Ste 102
Virginia Beach, VA 23452-7433
Phone
(757) 453-1256
Fax
(319) 359-3813
NPI assigned
Mar 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Authorized official

Name
Dr. Olivia Reichenbacker, DNP, PMHNP-BCNPI 1831637990
Title
Owner, Nurse Practitioner
Phone
(319) 359-3810

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: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2624 Southern Blvd Ste 102
Virginia Beach, VA 23452-7433

Mailing address

2624 Southern Blvd Ste 102
Virginia Beach, VA 23452-7433
Phone (757) 453-1256

Other practice location 1

6802 Paragon Pl Ste 410
Richmond, VA 23230-1655
Phone (757) 453-1256

Other practice location 2

114 Nationwide Dr
Lynchburg, VA 24502-4271
Phone (757) 453-1256

National Provider Directory

National Provider Directory

Locations

2624 Southern Blvd
Ste 102
Virginia Beach, VA 23452
Phone (757) 453-1256

Practitioners & affiliated clinicians

Practitioners 6

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": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1841930328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 SOUTHERN BLVD STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527433",
            "telephone_number": "757-453-1256",
            "fax_number": "319-359-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 SOUTHERN BLVD STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527433",
            "telephone_number": "757-453-1256",
            "fax_number": "319-359-3813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6802 Paragon Pl Ste 410",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232301655",
            "country_code": "US",
            "telephone_number": "757-453-1256",
            "fax_number": "319-359-3813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "114 Nationwide Dr",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245024271",
            "country_code": "US",
            "telephone_number": "757-453-1256",
            "fax_number": "319-359-3813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BROOKSIDE PSYCHIATRIC SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "REICHENBACKER",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "OWNER, NURSE PRACTITIONER",
        "authorized_official_telephone_number": "319-359-3810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.