Provider Demographics
NPI:1538114335
Name:KAYSER, JOSEPH (PHD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:KAYSER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-4850
Mailing Address - Country:US
Mailing Address - Phone:434-979-3289
Mailing Address - Fax:434-979-1123
Practice Address - Street 1:914 E HIGH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-4850
Practice Address - Country:US
Practice Address - Phone:434-979-3289
Practice Address - Fax:434-979-1123
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001294103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007799276Medicaid
VA030088OtherANTHEM BCBS
VA082213OtherSOUTHERN HEALTH
VA030088OtherANTHEM BCBS
VA680000652Medicare ID - Type UnspecifiedMEDICARE