Ethos Leadership Project, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024170504 Issued in VA

Legal business name

ETHOS LEADERSHIP PROJECT, LLC

Doing business as

The ETHOS Leadership Group

Practice address

1322 Lasalle Ave
Suite a
Hampton, VA 23669-3810

Phone

(757) 251-6367

NPI assigned

Oct 9, 2013

Last updated

Oct 24, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Melissa M. Gomes, PH.D., PMHNP-BC

Title

Clinical Director

Phone

(757) 251-6367

Specialties & licenses 1

Addresses

Other names 1

• The ETHOS Leadership Group Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382572800000",
    "number": "1861829764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 LASALLE AVE",
            "address_2": "SUITE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236693810",
            "telephone_number": "757-251-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 LASALLE AVE",
            "address_2": "SUITE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236693810",
            "telephone_number": "757-251-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHOS LEADERSHIP PROJECT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-10-24",
        "status": "A",
        "authorized_official_last_name": "GOMES",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "757-251-6367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024170504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The ETHOS Leadership Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Espinosa, LCSW
• Alex Charles Essenmacher, M.D.
• Essential Piece Life Enrichment Services (Essential Piece)
• Carlos Estevez, PT
• Lyz Darmeys Estrada, RPH
• Jayla Marie Etienne
• Amber Evans
• Andrea Cherice Evans, RESIDENT LPC
• Paul Edward Evans III, MD
• Randi Lee Evans, LPC

• Psychiatric/Mental Health Nurse Practitioner in Hampton, VA
• Providers in Hampton, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.