Individual
DR. PORTIA DENEEN RAWLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
2010 OLD GREENBRIER RD STE G, CHESAPEAKE, VA 23320-2619
(757) 493-2912
(866) 730-6583
Mailing address
2010 OLD GREENBRIER RD STE G, CHESAPEAKE, VA 23320-2619
(757) 493-2912
(866) 730-6583
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
0810003069
VA
103TC0700X
Clinical Psychologist
3884
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010177669
—
VA
01
—
085601M
OPTIMA
VA
01
—
1639198153
VIRGINIA PREMIER
VA
01
—
180317
ANTHEM
VA
01
—
2248507
CIGNA
VA
01
—
450517829
TRI CARE NORTH
VA
05
—
6001245
—
NC
01
—
7277741
AETNA
VA
01
—
SC0001033
MEDICARE
VA
Enumeration date
07/18/2006
Last updated
02/16/2023
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