Provider Demographics
NPI:1972725935
Name:HITE, CREIGHTON JONES (PSYD)
Entity type:Individual
Prefix:DR
First Name:CREIGHTON
Middle Name:JONES
Last Name:HITE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 FOREST AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3792
Mailing Address - Country:US
Mailing Address - Phone:804-285-4121
Mailing Address - Fax:804-285-4123
Practice Address - Street 1:7301 FOREST AVE STE 201
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3792
Practice Address - Country:US
Practice Address - Phone:804-285-4121
Practice Address - Fax:804-285-4123
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003482103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1972725935Medicaid
013885G04Medicare PIN
VA1972725935Medicaid