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Organization
SOUTH CHESAPEAKE PSYCHIATRY
Active
Organization
SOUTH CHESAPEAKE PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN RAY PMHNP-BC (OWNER)
(850) 776-2545
Entity
Organization
Contact information
Practice address
200 CARMICHAEL WAY STE 604, CHESAPEAKE, VA 23322-2489
(850) 776-2545
(757) 257-1163
Mailing address
200 CARMICHAEL WAY STE 604, CHESAPEAKE, VA 23322-2489
(757) 908-2124
(757) 908-2320
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/03/2021
Last updated
04/02/2021
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