Peninsula Pediatric Psychiatry
Organization Active NPI Clinical Child & Adolescent Psychologist · Newport News, VA
NPI 1982776902 · NPPES record last updated Jun 7, 2008
Key facts
- NPI
- 1982776902
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Child & Adolescent Psychologist 103TC2200X
- License
- 0101230611 (VA)
- Legal business name
- PENINSULA PEDIATRIC PSYCHIATRY
- Practice address
- 12350 Jefferson Ave
Suite 190
Newport News, VA 23602-6951 - Phone
- (757) 881-9444
- NPI assigned
- Nov 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Julie B Trice, MD
- Title
- President
- Phone
- (757) 593-6792
Practitioners 3
-
Jill N Jones, PMHNP
-
Ellen Ruth Moriarty, LCSW
-
Julia Brown Trice, M.D.
National Provider Directory
Locations
12350 Jefferson Ave
Ste 190
Newport News, VA 23602
Phone (757) 881-9444
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist |
103TC2200X | 0101230611 | VA | Yes |
| Clinical Social Worker |
1041C0700X | 05092005 | VA |
Addresses
Primary practice location
12350 Jefferson Ave
Suite 190
Newport News, VA 23602-6951
Mailing address
12350 Jefferson Ave
Suite 190
Newport News, VA 23602-6951
Phone (757) 881-9444
Other providers in Newport News, VA
- Peninsula Pain and Rehabilitation Center, Inc.
- Peninsula Pastoral Counseling Center Inc.
- Peninsula Pathology Associates Incorporated
- Peninsula Pathology Associates of Virginia PLLC
- Peninsula Pediatric Dentistry, P.C.
- Peninsula Pediatrics LTD
- Peninsula Pharmacy Services
- Peninsula Pharmacy Services LLC
- Peninsula Pulmonary Associates PC
- Peninsula Radiological Associates Limited
All providers in Newport News, VA · Clinical Child & Adolescent Psychologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2008. 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.