Lakeside Psychological Center Pc in Virginia Beach - Psychologist
Lakeside Psychological Center Pc - NPI 1104044528
Lakeside Psychological Center Pc is a Psychologist in Virginia Beach, Virginia. Lakeside Psychological Center Pc practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Lakeside Psychological Center Pc is 1104044528. The last update date is 2010-09-01.
Lakeside Psychological Center Pc's current location address is 3076 Brickhouse Ct, Virginia Beach, Virginia. You can contact this provider via phone number 7574860909 and fax number 7573407518. The mailing address for Lakeside Psychological Center Pc is 3076 Brickhouse Ct, Virginia Beach, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lakeside Psychological Center Pc |
|---|---|
| Address | 3076 Brickhouse Ct, Virginia Beach, Virginia |
| Phone Number | 7574860909 |
| Fax Number | 7573407518 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT, |
|---|---|
| Authorized Official Name | Stevens M Theodore |
| Credentials | PHD |
| Telephone Number | 7574860909 |
NPI Number Detail
| NPI Number | 1104044528 |
|---|---|
| Provider Enumeration Date | 2007-04-23 |
| Last Updated Date | 2010-09-01 |
Provider Mailing Address Detail
| Address | 3076 Brickhouse Ct |
|---|---|
| City | Virginia Beach |
| State | Virginia (VA) |
| Post Code | 234526859 |
| Phone Number | 7574860909 |
| Fax Number | 7573407518 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 90801000970 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1790811040 | VA | NPI | |
| 1104044528 | VA | CORPORATE NPI |
Post Comment/ Review Below
What is the unique provider identifier assigned to Lakeside Psychological Center Pc?
The Lakeside Psychological Center Pc has been issued the NPI (National Provider Identifier) 1104044528 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete physical address where Lakeside Psychological Center Pc is located?
The Lakeside Psychological Center Pc is situated at the following address: 3076 Brickhouse Ct, Virginia Beach, VA, 234526859.
What is Lakeside Psychological Center Pc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Lakeside Psychological Center Pc's specialized field of practice is Psychologist, and the corresponding taxonomy code that categorizes this area of specialization is 103T00000X.
When did the Lakeside Psychological Center Pc receive its 1104044528?
The Lakeside Psychological Center Pc was issued its 1104044528 on 2007-04-23, which is the date when the organization was assigned this unique identifier.
When was the information regarding Lakeside Psychological Center Pc most recently updated?
The details pertaining to the Lakeside Psychological Center Pc, including its address, specialty, and other relevant information, were last refreshed on 2010-09-01.