# IVY HEALTH AND PSYCHOLOGICAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528658416
- **Authorized official:** LATOYA MULLEN FNP-BC, PMHNP-BC (OWNER)
- **Authorized official phone:** (757) 202-6461

## Contact information

- **Practice address:** 1577 WILROY RD STE 102, SUFFOLK, VA 23434-2433
- **Practice address phone:** (757) 202-6461
- **Practice address fax:** (757) 257-9173
- **Mailing address:** PO BOX 12731, NORFOLK, VA 23541-0731

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/25/2021
- **Last updated:** 01/23/2022