Provider Demographics
NPI:1477535748
Name:PRITCHARD, CAROL THOMASON I (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:THOMASON
Last Name:PRITCHARD
Suffix:I
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 43RD ST
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-2503
Mailing Address - Country:US
Mailing Address - Phone:757-437-0000
Mailing Address - Fax:757-422-2842
Practice Address - Street 1:219 43RD ST
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-2503
Practice Address - Country:US
Practice Address - Phone:757-437-0000
Practice Address - Fax:757-422-2842
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001542103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA133041OtherMANAGED HEALTH NETWORK
VA133041OtherHEALTHNET
VA7707673OtherVIRGINIA PREMIER
VA140003OtherANTHEM HEALTHKEEPERS PLUS
VA085342OtherOPTIMA HEALTHCARE
343796OtherMDIPA
89366OtherPHCS
NC6000620OtherMEDICAID
021770OtherVALUE OPTIONS
VA461121OtherANTHEM BLUECROSSBLUESHIEL
VA5526268OtherAETNA
VA133041OtherHEALTHNET
343796OtherMDIPA