Organization
ON CALL PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CLINTON C TYSON (DIRECTOR OF OPERATIONS)
(209) 769-3420
Entity
Organization
Contact information
Practice address
751 THIMBLE SHOALS BLVD STE N, NEWPORT NEWS, VA 23606-3563
(757) 223-0500
Mailing address
8 ROYAL OAK CT, HAMPTON, VA 23666-6033
(757) 223-0500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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