Provider Demographics
NPI:1124589288
Name:GEORGETOWN NEUROPSYCHOLOGY LLC
Entity Type:Organization
Organization Name:GEORGETOWN NEUROPSYCHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:NOYES
Authorized Official - Last Name:STARBUCK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:202-343-2233
Mailing Address - Street 1:2233 WISCONSIN AVE NW STE 307
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-4104
Mailing Address - Country:US
Mailing Address - Phone:202-342-2233
Mailing Address - Fax:
Practice Address - Street 1:2233 WISCONSIN AVE NW STE 307
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-4104
Practice Address - Country:US
Practice Address - Phone:202-342-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty