Provider Demographics
NPI:1578743027
Name:NEUROPSYCHOLOGICAL ASSOCIATES OF WINCHESTER PLLC
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGICAL ASSOCIATES OF WINCHESTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVISON
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:540-662-3400
Mailing Address - Street 1:134 W PICCADILLY STREET
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601
Mailing Address - Country:US
Mailing Address - Phone:540-662-3400
Mailing Address - Fax:540-667-1394
Practice Address - Street 1:134 W PICCADILLY STREET
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601
Practice Address - Country:US
Practice Address - Phone:540-662-3400
Practice Address - Fax:540-667-1394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0810002168103T00000X
VA0810003809103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty