COLONIAL PSYCHIATRIC ASSOCIATES, LLC
NPI 1235636069
Clinic/Center - Mental Health (Including Community Mental Health Center) in Newport News, VA

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QM0801X and a focus in Mental Health (Including Community Mental Health Center).

Active since April 09, 2018

708 MOBJACK PL, NEWPORT NEWS, VA 23606(757) 873-1958(757) 873-2143 Get Directions Write a Review

NPPES record last updated: April 9, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Colonial Psychiatric Associates, Llc NPPES

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

COLONIAL PSYCHIATRIC ASSOCIATES, LLC (NPI 1235636069) is a healthcare organization registered as a mental health (including community mental health center) in Newport News, Virginia and active in the NPI registry since April 2018. The organization lists Wendy Burch, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1235636069

Entity TypeOrganization

Primary Taxonomy261QM0801X

Legal Business NameCOLONIAL PSYCHIATRIC ASSOCIATES, LLC

Location Address708 MOBJACK PLNewport News, VA 23606-1957

Mailing Address708 Mobjack PlNewport News, VA 23606-1957 · (757) 873-1958 · Fax (757) 873-2143

Phone(757) 873-1958

Fax(757) 873-2143

Organization SubpartNo

Authorized OfficialWendy BurchOffice Manager · (757) 873-1958

Enumeration DateApril 9, 2018

✔ NPI 1235636069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities

Taxonomy Code261QM0801X

708 MOBJACK PL, Newport News, VA 23606

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D1079126

Colonial Gastroenterology Associates Division Of Capital Digestive Care · Newport News, VA

Expired · Jan 23, 2026

CLIA Number49D1079126

Laboratory TypeMobile Laboratory

Certificate Effective DateJanuary 24, 2024

Certificate Expiration DateJanuary 23, 2026

Laboratory DirectorRavi Chhatrala

Laboratory Phone(757) 534-7705

Laboratory LocationColonial Gastroenterology Associates Division Of Capital Digestive Care11803 Jefferson Avenue # 230, Newport News, VA 23606

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 19

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

DR. CASSIANNE SUMMERLIN BOOTH PH.D.

Psychologist (Clinical)