Provider Demographics
NPI:1588733893
Name:CHARIS INSTITUTE FOR PSYCHOLOGICAL AND FAMILY SERVICES
Entity type:Organization
Organization Name:CHARIS INSTITUTE FOR PSYCHOLOGICAL AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:540-568-1876
Mailing Address - Street 1:36 SOUTHGATE CT
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-9668
Mailing Address - Country:US
Mailing Address - Phone:540-568-1876
Mailing Address - Fax:540-574-6076
Practice Address - Street 1:36 SOUTHGATE CT
Practice Address - Street 2:SUITE 102
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-9668
Practice Address - Country:US
Practice Address - Phone:540-568-1876
Practice Address - Fax:540-574-6076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001674103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7700482Medicaid
VA1326146713OtherRANDY WEBER, NPI
VA1275631673OtherRONDA WEBER NPI
VA7708572Medicaid
VA7708572Medicaid