| Organization Name: | PSYCHIATRIC SERVICES OF VIRGINIA |
| NPI Number: | 1003828799 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEORGE NEWTON DESHAZO (OWNER) |
| Mailing Address: | 708 Mobjack Pl Newport News |
| State: | VA US |
| Postal Code: | 236061957 |
| Phone Number: | 7578731958 |
| Fax Number: | 7578732143 |
| NPI Enumeration Date: | 08/12/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0701001314 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |