Organization
SHAPING YOUR FUTURE PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRISHA NARDIA PARKER (CEO)
(757) 528-2850
Entity
Organization
Contact information
Practice address
3082 BRICKHOUSE CT STE B, VIRGINIA BEACH, VA 23452-6859
(757) 528-2850
(757) 432-3159
Mailing address
4300 PORTSMOUTH BLVD UNIT 9183, CHESAPEAKE, VA 23321-0607
(757) 528-2850
(757) 432-3159
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
08/20/2020
Last updated
09/06/2024
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