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WESTERN TIDEWATER COMMUNITY SERVICES BOARD
NPI 1164416533
Clinic/Center - Adolescent and Children Mental Health in Suffolk, VA

Active since August 31, 2005
5268 GODWIN BLVD, SUFFOLK, VA 23434(757) 255-7100 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Western Tidewater Community Services Board NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WESTERN TIDEWATER COMMUNITY SERVICES BOARD (NPI 1164416533) is a healthcare organization registered as an adolescent and children mental health in Suffolk, Virginia and active in the NPI registry since August 2005. The organization lists Emily Bowe Hughes, Clinician, as its authorized official.

NPPES Registry Identity

NPI1164416533
Entity TypeOrganization
Primary Taxonomy261QM0855X
Legal Business NameWESTERN TIDEWATER COMMUNITY SERVICES BOARD
Location Address5268 GODWIN BLVDSuffolk, VA 23434-8135
Mailing Address5268 Godwin BlvdSuffolk, VA 23434-8135 · (757) 255-7100
Phone(757) 255-7100
Organization SubpartNo
Authorized OfficialEmily Bowe HughesClinician · (757) 255-7113
Enumeration DateAugust 31, 2005
Last NPPES UpdateAugust 22, 2020
✔ NPI 1164416533 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0855X
License✔ Licensed in VA · 0904002622
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
5268 GODWIN BLVD, Suffolk, VA 23434
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Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LUCIANNE W WARREN LCSW
Counselor (Mental Health)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7117
DR. SHERONDA FARROW PH.D.
Psychologist (Clinical)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7113
MISS SHACONDA LARECE HOLLOWAY L.C.S.W.
Social Worker (Clinical)
5268 GODWIN BLVD, WESTERN TIDEWATER MENTAL HEALTH
SUFFOLK, VA 23434
Suffolk City (757) 255-7117
WESTERN TIDEWATER COMMUNITY MENTAL
Non-emergency Medical Transport (VAN)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7117
MR. DEMETRIOS N PERATSAKIS PD, MS, LPC
Counselor (Professional)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7126
TIFFANY FOX, FOX
Social Worker (Clinical)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7133
BERNADETTE DENISE WARD LPC
Counselor (Professional)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7107
MS. PATRICIA RAE THORNES LPC
Counselor (Professional)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-2662

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Western Tidewater Community Services Board's NPI number?

The NPI number for Western Tidewater Community Services Board is 1164416533. It was assigned to this organization in the NPPES registry on August 31, 2005.

Where is Western Tidewater Community Services Board located?

Western Tidewater Community Services Board is located at 5268 Godwin Blvd, Suffolk, VA 23434. The listed phone number is (757) 255-7100.

What is Western Tidewater Community Services Board's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

When was this NPI record last updated?

The NPPES record for Western Tidewater Community Services Board was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.