Provider Demographics
NPI:1366125569
Name:NOMADIC BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:NOMADIC BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, FNP-BC
Authorized Official - Phone:804-531-4732
Mailing Address - Street 1:1405 S FERN ST # 98484
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-2810
Mailing Address - Country:US
Mailing Address - Phone:804-531-4732
Mailing Address - Fax:804-999-0385
Practice Address - Street 1:1806 SUMMIT AVE STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4339
Practice Address - Country:US
Practice Address - Phone:804-464-8301
Practice Address - Fax:804-964-3159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health