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Contact Information

MIDDLE PENINSULA-NORTHERN NECK MENTAL HEALTH AND MENTAL RETARDATION
5372B OLD VIRGINIA STREET
URBANNA, VA23175
 Phone: 804-758-5250
 Fax: 804-758-5183
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for MIDDLE PENINSULA NORTHERN NECK MENTAL HEALTH AND MENTAL RETARDATION · (Female)

NPI Number 1992879282
Status Active
Credentials
Entity Individual
Enumeration date 11/20/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Not specified
Identifiers
  • VA License # 2202000605
  • VA License # 2202002885
  • VA License # 2305002514
  • VA License # 2305006727
  • VA Medicaid 4978137
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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