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Western Tidewater Community Services Board
Adolescent and Children Mental Health Clinic/Center in Suffolk, Virginia
NPI 1164416533

Western Tidewater Community Services Board is an Adolescent and Children Mental Health Clinic/Center based in Suffolk, VA and is specialized in Adolescent and Children Mental Health. Western Tidewater Community Services Board practices in Suffolk, VA. The NPI Number for Western Tidewater Community Services Board is 1164416533 and holds a License No. 0904002622 (Virginia).

The current practice location address for Western Tidewater Community Services Board is 5268 Godwin Blvd, Suffolk, VA and can be reached out via phone at 757-255-7100.

Location: 5268 Godwin Blvd, Suffolk, VA, 23434-8135
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164416533
Provider Name
Western Tidewater Community Services Board
Credential
Provider Entity Type
Organization
Address
5268 Godwin Blvd, Suffolk, VA, 23434-8135
Phone Number
757-255-7100
Fax Number
Provider Enumeration Date
08/31/2005
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
5268 Godwin Blvd
City
Suffolk
State
Virginia
Zip
23434-8135
Phone Number
757-255-7100
Fax Number
person
Provider Business Mailing Address Details
Address
5268 Godwin Blvd
City
Suffolk
State
Virginia
Zip
23434-8135
Phone Number
757-255-7100
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
0904002622 (Virginia)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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