Provider Demographics
NPI:1528388501
Name:PATRICIA VELKOFF, PH.D., P.C.
Entity Type:Organization
Organization Name:PATRICIA VELKOFF, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-938-6100
Mailing Address - Street 1:243 CHURCH ST NW
Mailing Address - Street 2:SUITE 300-A
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4434
Mailing Address - Country:US
Mailing Address - Phone:703-938-6100
Mailing Address - Fax:703-938-8393
Practice Address - Street 1:243 CHURCH ST NW
Practice Address - Street 2:SUITE 300-A
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4434
Practice Address - Country:US
Practice Address - Phone:703-938-6100
Practice Address - Fax:703-938-8393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001677261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)