Jack Eugene Mallery in Norfolk - Peer Specialist
Jack Eugene Mallery - NPI 1700969383
Jack Eugene Mallery is a Peer Specialist in Norfolk, Virginia. Jack Eugene Mallery practices all healthcare services and medical treatments related to Peer Specialist. The NPI Number for Jack Eugene Mallery is 1700969383. The last update date is 2022-12-12.
Jack Eugene Mallery's current location address is 7305 Hampton Blvd, Norfolk, Virginia. You can contact this provider via phone number 7576232700 and fax number 7576401058. The mailing address for Jack Eugene Mallery is 7305 Hampton Blvd, Norfolk, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack Eugene Mallery |
|---|---|
| Address | 7305 Hampton Blvd, Norfolk, Virginia |
| Phone Number | 7576232700 |
| Fax Number | 7576401058 |
| Sole Proprietor | N |
| Credentials | LPC |
NPI Number Detail
| NPI Number | 1700969383 |
|---|---|
| Provider Enumeration Date | 2006-10-24 |
| Last Updated Date | 2022-12-12 |
Provider Mailing Address Detail
| Address | 7305 Hampton Blvd |
|---|---|
| City | Norfolk |
| State | Virginia (VA) |
| Post Code | 235052908 |
| Phone Number | 7576232700 |
| Fax Number | 7576401058 |
Provider's Primary Taxonomy Detail
| Speciality | Peer Specialist |
|---|---|
| Taxonomy | 175T00000X |
|
Definition: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4945395 | VA | PROVIDER NUMBER | |
| 175080 | VA | PROVIDER NUMBER | |
| 4945395 | VA | -- | |
| 083239M | VA | PROVIDER NUMBER |
Post Comment/ Review Below
What is the Jack Eugene Mallery's unique identification number?
The Jack Eugene Mallery has been assigned the NPI (National Provider Identifier) Number 1700969383 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Jack Eugene Mallery is physically located?
The Jack Eugene Mallery is situated at the following address: 7305 Hampton Blvd, Norfolk, VA 235052908.
What is the Jack Eugene Mallery's area of specialization and corresponding taxonomy classification?
The Jack Eugene Mallery's specialty field is Peer Specialist, and it falls under the taxonomy code 175T00000X, which categorizes healthcare providers based on their specialties.
On what date did the Jack Eugene Mallery receive its 1700969383 assignment from the Centers for Medicare & Medicaid Services?
The Jack Eugene Mallery was assigned its 1700969383 by the Centers for Medicare & Medicaid Services on 2006-10-24.
As of what date were the details related to Jack Eugene Mallery most recently updated or revised?
The information pertaining to Jack Eugene Mallery, including its address, specialty, and other relevant details, was last updated or revised on 2022-12-12.