Provider Demographics
NPI:1922834795
Name:DELBRIDGE, AKEISHER (CEO)
Entity type:Individual
Prefix:
First Name:AKEISHER
Middle Name:
Last Name:DELBRIDGE
Suffix:
Gender:F
Credentials:CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19255 BREVARD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23834-4611
Mailing Address - Country:US
Mailing Address - Phone:804-253-3462
Mailing Address - Fax:
Practice Address - Street 1:3501 BOULEVARD
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1319
Practice Address - Country:US
Practice Address - Phone:804-253-3462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician