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Organization
BRIGHT SHADOWS TELEPSYCHIATRY SERVICES, PLLC
Active
Organization
BRIGHT SHADOWS TELEPSYCHIATRY SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONDESHYA KEYONNA COSBY NP (OWNER)
(252) 751-5103
Entity
Organization
Contact information
Practice address
4410 CLAIBORNE SQ E, HAMPTON, VA 23666-2071
(252) 751-5103
(252) 751-5127
Mailing address
PO BOX 9244, HAMPTON, VA 23670-0244
(252) 751-5103
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
02/28/2024
Last updated
02/28/2024
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