Provider Demographics
NPI:1720119365
Name:COMMUNITY PSYCHOLOGICAL RESOURCES, P.C.
Entity type:Organization
Organization Name:COMMUNITY PSYCHOLOGICAL RESOURCES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-622-6794
Mailing Address - Street 1:249 W YORK ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1520
Mailing Address - Country:US
Mailing Address - Phone:757-622-6794
Mailing Address - Fax:
Practice Address - Street 1:249 W YORK ST
Practice Address - Street 2:SUITE A
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1520
Practice Address - Country:US
Practice Address - Phone:757-622-6794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty