| Western Tidewater Community Mental | |
|
7025 Harbour View Blvd Ste 119 Suffolk VA 23435-2762 | |
| (757) 966-2805 | |
| (757) 673-2586 |
| Full Name | Western Tidewater Community Mental |
|---|---|
| Speciality | Clinic/Center |
| Location | 7025 Harbour View Blvd Ste 119, Suffolk, Virginia |
| Authorized Official Name and Position | Marion Young (REIMBURSEMENT SUPERVISOR) |
| Authorized Official Contact | 7576879087 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Tidewater Community Mental 7025 Harbour View Blvd Ste 119 Suffolk VA 23435-2762 Ph: (757) 966-2805 | Western Tidewater Community Mental 7025 Harbour View Blvd Ste 119 Suffolk VA 23435-2762 Ph: (757) 966-2805 |
| NPI Number | 1689615296 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 09/18/2025 |
| Certification Date | 09/18/2025 |
| Medicare PECOS PAC ID | 2961476114 |
|---|---|
| Medicare Enrollment ID | O20040823001494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689615296 | NPI | - | NPPES |
| 270369 | Other | VA | ANTHEM GROUP NUMBER |
| 004945310 | Medicaid | VA | |
| 1689615296 | Medicaid | VA |
| Provider Name | Frank A Roberto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669467254 PECOS PAC ID: 6406810233 Enrollment ID: I20041112000163 |
| Provider Name | Luis F Ignacio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710025333 PECOS PAC ID: 1850391624 Enrollment ID: I20061228000399 |
| Provider Name | Lisa A Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225200066 PECOS PAC ID: 6305908674 Enrollment ID: I20081219000490 |
| Provider Name | Dierich M Kaiser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205990256 PECOS PAC ID: 6901943513 Enrollment ID: I20100811000961 |
| Provider Name | Yolanda Yvonne Gill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356632509 PECOS PAC ID: 2567649544 Enrollment ID: I20110531000054 |
| Provider Name | Stephanie Harrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740318344 PECOS PAC ID: 9739496274 Enrollment ID: I20150916002453 |
| Provider Name | Margot Veronica Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780945469 PECOS PAC ID: 7315194990 Enrollment ID: I20160624000217 |
| Provider Name | Tiffaney Joy Dunbar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891926143 PECOS PAC ID: 6608112586 Enrollment ID: I20190114003027 |
| Provider Name | Danielle Kashaija |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043630213 PECOS PAC ID: 8325388333 Enrollment ID: I20190328001382 |
| Provider Name | Lacrezia R Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700364908 PECOS PAC ID: 8820330335 Enrollment ID: I20190502003128 |
| Provider Name | Mariam Aderoju Dosunmu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912460429 PECOS PAC ID: 6901132083 Enrollment ID: I20190806001195 |
| Provider Name | Tanetta Hassell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962066258 PECOS PAC ID: 9133457617 Enrollment ID: I20190821003131 |
| Provider Name | Teresa Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184377681 PECOS PAC ID: 2163889684 Enrollment ID: I20230526001863 |
| Provider Name | Cassandra Bradford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891477956 PECOS PAC ID: 0648610543 Enrollment ID: I20240425001366 |
| Provider Name | Blair Labudovich |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679211635 PECOS PAC ID: 5890238281 Enrollment ID: I20240613001360 |
| Provider Name | Brittany Sesek |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891368809 PECOS PAC ID: 4183167513 Enrollment ID: I20240613003167 |
| Provider Name | Jessica L Schwartz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952986382 PECOS PAC ID: 1153864517 Enrollment ID: I20240613004469 |
| Provider Name | Chakia Nicole Stallings |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942040894 PECOS PAC ID: 6709329048 Enrollment ID: I20240614003186 |
| Provider Name | Chelsea Elizabeth Jefferson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932812864 PECOS PAC ID: 5092258343 Enrollment ID: I20240614003546 |
| Provider Name | Bernadette Denise Ward |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356877310 PECOS PAC ID: 2769928555 Enrollment ID: I20240729003736 |
| Provider Name | Tajh-marie Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710721220 PECOS PAC ID: 3678004512 Enrollment ID: I20241003000701 |
| Provider Name | Deloris L Shaw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548974256 PECOS PAC ID: 2668905175 Enrollment ID: I20241023000054 |
| Provider Name | Cathy Manier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376072728 PECOS PAC ID: 1254866882 Enrollment ID: I20241120000053 |
| Provider Name | Miata M Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477372746 PECOS PAC ID: 6608301783 Enrollment ID: I20241126002966 |
| Provider Name | Nikelah R Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073335352 PECOS PAC ID: 4688100613 Enrollment ID: I20241213000300 |
| Provider Name | Kymberlie Sherri Brooks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205614351 PECOS PAC ID: 6800323494 Enrollment ID: I20241220000335 |
| Provider Name | Michelle Wiggins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790505436 PECOS PAC ID: 4587192513 Enrollment ID: I20250103002722 |
| Provider Name | Latasha Filhiol |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396551446 PECOS PAC ID: 2163950973 Enrollment ID: I20250107003646 |
| Provider Name | Samantha Rhiannon Leto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205356623 PECOS PAC ID: 5092243170 Enrollment ID: I20250117000482 |
| Provider Name | Damara Beckett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174135651 PECOS PAC ID: 5092236075 Enrollment ID: I20250306001285 |
| Provider Name | Yvonne Judge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164933446 PECOS PAC ID: 8628471844 Enrollment ID: I20250306001680 |
| Provider Name | D'ericka L Fulgham-artis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033943998 PECOS PAC ID: 1153842158 Enrollment ID: I20250306002288 |
| Provider Name | Karen E Bailey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912499591 PECOS PAC ID: 7618498635 Enrollment ID: I20250306002865 |
| Provider Name | Landria Edwards |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790519650 PECOS PAC ID: 7517488356 Enrollment ID: I20250310000537 |
| Provider Name | Karen Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457022303 PECOS PAC ID: 7810342615 Enrollment ID: I20250310000905 |
| Provider Name | Amy Byrne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992361588 PECOS PAC ID: 3870014632 Enrollment ID: I20250310001081 |
| Provider Name | Crystal Clary |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598483851 PECOS PAC ID: 3678094463 Enrollment ID: I20250310001889 |
| Provider Name | Cynthia S Ellison |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326309535 PECOS PAC ID: 4183145840 Enrollment ID: I20250311000402 |
| Provider Name | Towanna Morgan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336710466 PECOS PAC ID: 8921520354 Enrollment ID: I20250314002086 |
| Provider Name | Natalia Tague |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134666704 PECOS PAC ID: 1355863366 Enrollment ID: I20250319003317 |
| Provider Name | Lorrie Saunders Gaskins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902522063 PECOS PAC ID: 5890228613 Enrollment ID: I20250319003782 |
| Provider Name | Patricia Thornes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447415716 PECOS PAC ID: 8527580471 Enrollment ID: I20250320000204 |
| Provider Name | Courtney G Mccoy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619229937 PECOS PAC ID: 6103217427 Enrollment ID: I20250320001285 |
| Provider Name | Staci Young |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144479379 PECOS PAC ID: 4981126687 Enrollment ID: I20250324000352 |
| Provider Name | Richard Turner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962230698 PECOS PAC ID: 8123540754 Enrollment ID: I20250324001509 |
| Provider Name | Angela Mckinley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841053386 PECOS PAC ID: 5294257879 Enrollment ID: I20250324002753 |
| Provider Name | Theresa Murch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942537584 PECOS PAC ID: 5092237685 Enrollment ID: I20250324003253 |
| Provider Name | Patrice Owens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467118067 PECOS PAC ID: 4688197270 Enrollment ID: I20250324003392 |
| Provider Name | Courtney Goolsby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720419872 PECOS PAC ID: 1658895008 Enrollment ID: I20250408001188 |
| Provider Name | Natalie K Horne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518684679 PECOS PAC ID: 0042735177 Enrollment ID: I20250422000055 |
| Provider Name | Brittany Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902314313 PECOS PAC ID: 0840716403 Enrollment ID: I20250428000074 |
| Provider Name | Justina Lambert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295448652 PECOS PAC ID: 4486170941 Enrollment ID: I20250428002506 |
| Provider Name | Sharon Spohn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174606347 PECOS PAC ID: 3072039551 Enrollment ID: I20250428002946 |
| Provider Name | Andrea Washington |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952118986 PECOS PAC ID: 2365968757 Enrollment ID: I20250429001728 |
| Provider Name | Juliette M Thompson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063224657 PECOS PAC ID: 9739605080 Enrollment ID: I20250429002791 |
| Provider Name | Karin Duncan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730317116 PECOS PAC ID: 5991221251 Enrollment ID: I20250429003161 |
| Provider Name | Vonda Warren-lilly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669059432 PECOS PAC ID: 0446776728 Enrollment ID: I20250429003612 |
| Provider Name | Adeline Ndipisiri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063171650 PECOS PAC ID: 2769908052 Enrollment ID: I20250429003812 |
| Provider Name | Whitney Wade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891365151 PECOS PAC ID: 6002332327 Enrollment ID: I20250430000795 |
| Provider Name | Cherelle Baylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245095322 PECOS PAC ID: 9436675634 Enrollment ID: I20250430003293 |
| Provider Name | Stephanie Vuori |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376201913 PECOS PAC ID: 6204353162 Enrollment ID: I20250505003142 |
| Provider Name | Sara Throckmorton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265901789 PECOS PAC ID: 1052838620 Enrollment ID: I20250507001277 |
| Provider Name | Latashi Gunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649987926 PECOS PAC ID: 3678090297 Enrollment ID: I20250507002287 |
| Provider Name | Michelle Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518649839 PECOS PAC ID: 5698292134 Enrollment ID: I20250507003306 |
| Provider Name | Larhonda N Armstrong-bailey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740058627 PECOS PAC ID: 2466979885 Enrollment ID: I20250509000029 |
| Provider Name | Christina M Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023835071 PECOS PAC ID: 1850818139 Enrollment ID: I20250509001281 |
Anchor Of Hope Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1055 Fairgrounds Ln, Suffolk, VA 23434 Phone: 757-541-3851 | |
Sentara Medical Group Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2790 Godwin Blvd, Suite 235, Suffolk, VA 23434 Phone: 757-934-4580 Fax: 757-510-9218 | |
Ally Aba Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 W Washington St Ste 4, Suffolk, VA 23434 Phone: 757-547-6203 | |
5 Star Residential Care Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5024 Kelso St, Suffolk, VA 23435 Phone: 336-926-0133 | |
Me For Me Counseling And Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 Preserve Way, Suffolk, VA 23434 Phone: 757-329-5364 | |
Institute For Family Centered Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7021 Harbour View Blvd, Suite 102, Suffolk, VA 23435 Phone: 757-484-4179 Fax: 757-484-1341 | |
Paradigm Mental Health Services Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4112 Pritchard Street Suffolk Va. 23435, Suffolk, VA 23435 Phone: 757-957-2098 |