Western Tidewater Community Services Board – Mental Health Clinic/Center (Including Community Mental Health Center), NPI 1689615296
Mental Health Clinic/Center (Including Community Mental Health Center)
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Western Tidewater Community Services Board
1000 Commercial Ln
Suffolk, VA 234348148
Phone: (757) 942-1069
Fax: (757) 925-2213
Type: Location
641 Adkins Cir
Suffolk, VA 234343301
Phone: (757) 966-2805
Fax: (757) 673-2586
Type: Location
130 Suburban Dr
Suffolk, VA 234342625
Phone: (757) 966-2805
Fax: (757) 673-2586
Type: Location
200 E 2nd Ave
Franklin, VA 238511506
Phone: (757) 562-2208
Fax: (757) 925-2296
Type: Location
135 S Saratoga St
Suffolk, VA 234345322
Phone: (757) 935-5160
Type: Location
5268 Godwin Blvd
Suffolk, VA 234348114
Phone: (757) 266-7131
Fax: (757) 255-7128
Type: Location
805 Jefferson St
Suffolk, VA 234344068
Phone: (757) 966-2805
Fax: (757) 673-2586
Type: Location
1428 Big Bethel Rd
Hampton, VA 236661409
Phone: (757) 966-2805
Fax: (757) 673-2586
Type: Location
1913 S Church St Ste 2
Smithfield, VA 234301852
Phone: (757) 357-7458
Fax: (757) 356-1808
Type: Location
16022 Everets Rd
Windsor, VA 234876054
Phone: (757) 966-2805
Fax: (757) 673-2586
Type: Location
Harbour View Boulevard, Harbour View, Huntersville, Suffolk, Virginia, 23435, United States
SUFFOLK, VA 234352762
Phone: (757) 966-2805
Fax: (757) 673-2586
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-08-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040823001494 | O | Clinic/Group Practice | VA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 23434)
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