Provider Demographics
NPI:1538499579
Name:ISAAC, NATHANIEL D'URVILLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:D'URVILLE
Last Name:ISAAC
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 OLDE TOWNE RD STE C
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-1910
Mailing Address - Country:US
Mailing Address - Phone:630-936-8747
Mailing Address - Fax:
Practice Address - Street 1:2202 EXECUTIVE DR STE C
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-6604
Practice Address - Country:US
Practice Address - Phone:757-827-7707
Practice Address - Fax:757-838-2573
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL071008221103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1538499579Medicaid