WESTERN TIDEWATER COMMUNITY MENTAL
NPI 1689615296
Clinic/Center - Mental Health (Including Community Mental Health Center) in Suffolk, VA

Q: What is Western Tidewater Community Mental's NPI number?

The NPI number for Western Tidewater Community Mental is 1689615296. It was assigned to this organization in the NPPES registry on June 8, 2006. The provider is doing business as Western Tidewater Community Services Board.

Q: What is Western Tidewater Community Mental's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Active since June 08, 2006CLIA 49D2045667 · Waiver

7025 HARBOUR VIEW BLVD STE 119, SUFFOLK, VA 23435(757) 966-2805(757) 673-2586 Get Directions Write a Review

NPPES record last updated: January 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 23, 2026, Sep 18, 2025, May 17, 2023 and 2 more (5 updates tracked since 2018).

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About Western Tidewater Community Mental NPPES

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

WESTERN TIDEWATER COMMUNITY MENTAL (NPI 1689615296), doing business as Western Tidewater Community Services Board, is a healthcare organization registered as a mental health (including community mental health center) in Suffolk, Virginia and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through August 16, 2026, maintains 10 additional practice locations, and lists Marion Young, Reimbursement Supervisor, as its authorized official.

NPPES Registry Identity

NPI1689615296

Entity TypeOrganization

Primary Taxonomy261QM0801X

Legal Business NameWESTERN TIDEWATER COMMUNITY MENTAL

Location Address7025 HARBOUR VIEW BLVD STE 119Suffolk, VA 23435-2762

Mailing Address7025 Harbour View Blvd Ste 119Suffolk, VA 23435-2762 · (757) 966-2805 · Fax (757) 673-2586

Phone(757) 966-2805

Fax(757) 673-2586

Organization SubpartNo

Authorized OfficialMarion YoungReimbursement Supervisor · (757) 687-9087

Enumeration DateJune 8, 2006

Last NPPES UpdateJanuary 23, 20265 updates tracked since enumeration

NPPES CertifiedJanuary 23, 2026

✔ NPI 1689615296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 13

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

Taxonomy Code261QM0801X

Also ListedRegistered Nurse · Case ManagementTaxonomy 163WC0400X

Also ListedContractor · Home ModificationsTaxonomy 171WH0202X

Also ListedRehabilitation Counselor · Assistive Technology PractitionerTaxonomy 225CA2400X

Also ListedCase ManagementTaxonomy 251B00000X · License 084-16-001 (VA)

Also ListedDay Training, Developmentally Disabled ServicesTaxonomy 251C00000X

Also ListedNursing CareTaxonomy 251J00000X

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X

Also ListedIn Home Supportive CareTaxonomy 253Z00000X

Also ListedIntermediate Care Facility, Intellectual DisabilitiesTaxonomy 315P00000X

Also ListedPsychiatric Residential Treatment FacilityTaxonomy 323P00000X

Also ListedEmergency Response System CompaniesTaxonomy 333300000X

Also ListedNon-emergency Medical Transport (VAN)Taxonomy 343900000X

7025 HARBOUR VIEW BLVD STE 119, Suffolk, VA 23435

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Other Names 1

Doing Business AsWestern Tidewater Community Services Board

Secondary Practice Locations 10

Location 1200 E 2nd AveFranklin, VA 23851-1506 · Phone (757) 562-2208 · Fax (757) 925-2296

Location 2130 Suburban DrSuffolk, VA 23434-2625 · Phone (757) 966-2805 · Fax (757) 673-2586

Location 3641 Adkins CirSuffolk, VA 23434-3301 · Phone (757) 966-2805 · Fax (757) 673-2586

Location 41000 Commercial LnSuffolk, VA 23434-8148 · Phone (757) 942-1069 · Fax (757) 925-2213

Location 5135 S Saratoga StSuffolk, VA 23434-5322 · Phone (757) 935-5160

Location 65268 Godwin BlvdSuffolk, VA 23434-8114 · Phone (757) 266-7131 · Fax (757) 255-7128

Location 7805 Jefferson StSuffolk, VA 23434-4068 · Phone (757) 966-2805 · Fax (757) 673-2586

Location 81428 Big Bethel RdHampton, VA 23666-1409 · Phone (757) 966-2805 · Fax (757) 673-2586

Location 916022 Everets RdWindsor, VA 23487-6054 · Phone (757) 966-2805 · Fax (757) 673-2586

Location 101913 S Church St Ste 2Smithfield, VA 23430-1852 · Phone (757) 357-7458 · Fax (757) 356-1808

Other Identifiers 3

Other270369VA · Anthem Group Number

Medicaid004945310VA

Medicaid1689615296VA

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 49D2045667

Western Tidewater Community Services Board · Suffolk, VA

Active · expires Aug 16, 2026

CLIA Number49D2045667

Laboratory TypeOutpt Clinic

Certificate Effective DateAugust 17, 2024

Certificate Expiration DateAugust 16, 2026

Laboratory DirectorDieirch Kaiser

Laboratory Phone(757) 942-1069

Laboratory LocationWestern Tidewater Community Services Board1000 Commercial Lane, Suffolk, VA 23434

CLIA data matches this NPI record on: Address Name Phone

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

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Other Providers at the Same Location NPPES 20

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

DANIELLE BROWN KASHAIJA LCSW

Social Worker (Clinical)