Provider Demographics
NPI:1063249670
Name:ANGER MANAGEMENT HAMPTON ROADS LLC
Entity type:Organization
Organization Name:ANGER MANAGEMENT HAMPTON ROADS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:EDS, MDIV, LMFT
Authorized Official - Phone:757-589-0293
Mailing Address - Street 1:4224 QUAILSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-3197
Mailing Address - Country:US
Mailing Address - Phone:757-589-0293
Mailing Address - Fax:
Practice Address - Street 1:517 KEMPSVILLE RD STE F
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3643
Practice Address - Country:US
Practice Address - Phone:757-589-0293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty