Organization
CRIPPLED CHILDREN'S HOSPITAL
Active
Other names
Children's Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL G. WEIDMAN (VICE PREDIDENT & CFO)
(804) 321-7474
Entity
Organization
Contact information
Practice address
2924 BROOK RD, RICHMOND, VA 23220-1215
(804) 321-7474
(804) 321-2728
Mailing address
2924 BROOK RD, CHILDREN'S HOSPITAL CREDENTIALING DEPT, RICHMOND, VA 23220-1215
(804) 321-7474
(804) 321-2728
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
H1842
VA
103TC0700X
Clinical Psychologist
H1842
VA
1041C0700X
Clinical Social Worker
Primary
H1842
VA
Other
Enumeration date
04/10/2007
Last updated
09/11/2025
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