Provider Demographics
NPI:1366509218
Name:DEUBERT, WILLIAM G (PSYD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:G
Last Name:DEUBERT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1489 CHAIN BRIDGE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-5724
Mailing Address - Country:US
Mailing Address - Phone:703-268-8556
Mailing Address - Fax:
Practice Address - Street 1:1489 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-5724
Practice Address - Country:US
Practice Address - Phone:703-268-8556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002990103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical