Provider Demographics
NPI:1437688546
Name:CENTER FOR PSYCHOLOGICAL ASSESSMENT AND CONSULTATION PC
Entity Type:Organization
Organization Name:CENTER FOR PSYCHOLOGICAL ASSESSMENT AND CONSULTATION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:VAN BRUNT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:540-698-0003
Mailing Address - Street 1:615 JEFFERSON DAVIS HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8407
Mailing Address - Country:US
Mailing Address - Phone:540-698-0003
Mailing Address - Fax:540-212-2660
Practice Address - Street 1:510 PRINCESS ANNE ST STE 102
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-6077
Practice Address - Country:US
Practice Address - Phone:540-698-0003
Practice Address - Fax:540-212-2660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty