# ETHOS LEADERSHIP PROJECT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The ETHOS Leadership Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861829764
- **Authorized official:** DR. MELISSA M. GOMES PH.D., PMHNP-BC (CLINICAL DIRECTOR)
- **Authorized official phone:** (757) 251-6367

## Contact information

- **Practice address:** 1322 LASALLE AVE, SUITE A, HAMPTON, VA 23669-3810
- **Practice address phone:** (757) 251-6367
- **Mailing address:** 1322 LASALLE AVE, SUITE A, HAMPTON, VA 23669-3810
- **Mailing address phone:** (757) 251-6367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 0024170504 | VA | Yes |

## Other

- **Enumeration date:** 10/09/2013
- **Last updated:** 10/24/2013