Organization
MIDDLE PENINSULA-NORTHERN NECK MENTAL HEALTH AND MENTAL RETARDATION
Active
Other names
Rural Infant Services Program
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES R WALSH LCSW (EXECUTIVE DIRECTOR)
(804) 758-5314
Entity
Organization
Contact information
Practice address
5372B OLD VIRGINIA STREET, URBANNA, VA 23175
(804) 758-5250
(804) 758-5183
Mailing address
PO BOX 40, SALUDA, VA 23149-0040
(804) 758-5250
(804) 758-5138
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305002514
VA
225100000X
Physical Therapist
2305006727
VA
225X00000X
Occupational Therapist
—
VA
235Z00000X
Speech-Language Pathologist
2202000605
VA
235Z00000X
Speech-Language Pathologist
Primary
2202002885
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4978137
—
VA
Enumeration date
11/20/2006
Last updated
09/11/2025
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