Provider Demographics
NPI:1033182423
Name:FUSS, PATRICIA MARY (PSY D)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:MARY
Last Name:FUSS
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:MARY FUSS
Other - Last Name:REALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:780 LYNNHAVEN PKWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7332
Mailing Address - Country:US
Mailing Address - Phone:757-468-0550
Mailing Address - Fax:757-468-9992
Practice Address - Street 1:780 LYNNHAVEN PKWY
Practice Address - Street 2:SUITE 400 ATLANTIC PSYCHIATRIC SERVICES
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7332
Practice Address - Country:US
Practice Address - Phone:757-468-0550
Practice Address - Fax:757-468-9992
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002699103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
396732OtherANTHEM PPO BCBS
C01884OtherMCARE GROUP
084284OtherSENTARA OPTIMA
220019OtherMANAGED HEALTH NETWORK
255038OtherMAGELLAN
VA007710755Medicaid
269815OtherMAMSI
396732OtherANTHEM HEALTH KEEPERS
P00129357OtherMCARE RAILROAD