Stephen Carl Ganderson in Chesapeake - Clinical
Stephen Carl Ganderson - NPI 1902994262
Stephen Carl Ganderson is a Clinical in Chesapeake, Virginia. Stephen Carl Ganderson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Stephen Carl Ganderson is 1902994262. The last update date is 2007-07-08.
Stephen Carl Ganderson's current location address is Po Box 2739, Chesapeake, Virginia. You can contact this provider via phone number 7575489996 and fax number 7573825085. The mailing address for Stephen Carl Ganderson is Po Box 2739, Chesapeake, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stephen Carl Ganderson |
|---|---|
| Address | Po Box 2739, Chesapeake, Virginia |
| Phone Number | 7575489996 |
| Fax Number | 7573825085 |
| Sole Proprietor | Y |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1902994262 |
|---|---|
| Provider Enumeration Date | 2006-10-11 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | Po Box 2739 |
|---|---|
| City | Chesapeake |
| State | Virginia (VA) |
| Post Code | 233272739 |
| Phone Number | 7575489996 |
| Fax Number | 7573825085 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 810001638 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7704755 | VA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Stephen Carl Ganderson by the Centers for Medicare & Medicaid Services?
The Stephen Carl Ganderson has been assigned the NPI (National Provider Identifier) 1902994262. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Stephen Carl Ganderson is physically located?
The Stephen Carl Ganderson is situated at the following address: Po Box 2739, Chesapeake, VA 233272739.
What is Stephen Carl Ganderson's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Stephen Carl Ganderson is Clinical, and the corresponding taxonomy classification code for this specialized field is 103Tc0700X.
On what date did the Stephen Carl Ganderson receive the assignment of its 1902994262 from the Centers for Medicare & Medicaid Services?
The Stephen Carl Ganderson was issued its 1902994262 by the Centers for Medicare & Medicaid Services on 2006-10-11.
As of what date were the details related to Stephen Carl Ganderson most recently updated or revised?
The information pertaining to Stephen Carl Ganderson, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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