NPIMap

Organization Active NPI

Middle Peninsula-Northern Neck Mental Health and Mental Retardation

  • Speech-Language Pathologist
  • Urbanna, VA
National Provider Identifier
1992879282
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202002885 Issued in VA
Legal business name
MIDDLE PENINSULA-NORTHERN NECK MENTAL HEALTH AND MENTAL RETARDATION
Practice address
5372B Old Virginia Street
Urbanna, VA 23175
Phone
(804) 758-5250
Fax
(804) 758-5183
NPI assigned
Nov 20, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Charles R Walsh, LCSW
Title
Executive Director
Phone
(804) 758-5314

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 90

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 90

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130103000289 VA Part a Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 1254235989 Practice locations: Urbanna, VA

National Provider Directory

National Provider Directory
Tax ID family
Middle Peninsula Northern Neck Mental Health Retardation6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

330 Hospital Rd
Tappahannock, VA 22560
Phone (804) 695-8120

Specialties & licenses 5

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 2305006727 VA
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 2305002514 VA
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 2202000605 VA
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 2202002885 VA Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X VA

Addresses

NPPES NPI Registry

Primary practice location

5372B Old Virginia Street
Urbanna, VA 23175

Mailing address

PO Box 40
Saluda, VA 23149-0040
Phone (804) 758-5250

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
4978137MedicaidVA

Other names 1

NPPES NPI Registry
  • Rural Infant Services Program Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2025.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1992879282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "SALUDA",
            "state": "VA",
            "postal_code": "231490040",
            "telephone_number": "804-758-5250",
            "fax_number": "804-758-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5372B OLD VIRGINIA STREET",
            "city": "URBANNA",
            "state": "VA",
            "postal_code": "23175",
            "telephone_number": "804-758-5250",
            "fax_number": "804-758-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE PENINSULA-NORTHERN NECK MENTAL HEALTH AND MENTAL RETARDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-758-5314",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305006727",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305002514",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202000605",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202002885",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4978137",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rural Infant Services Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Urbanna, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.