Provider Demographics
NPI:1588647218
Name:ALBACH, KATHERINE CROFT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:CROFT
Last Name:ALBACH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:CROFT
Other - Last Name:HAWXHURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:289 INDEPENDENCE BLVD
Mailing Address - Street 2:STE 221 PEMBROKE 3
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462
Mailing Address - Country:US
Mailing Address - Phone:757-498-9320
Mailing Address - Fax:757-498-9321
Practice Address - Street 1:289 INDEPENDENCE BLVD
Practice Address - Street 2:STE 221 PEMBROKE 3
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:757-498-9320
Practice Address - Fax:757-498-9321
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003508103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA179952OtherANTHEM
VA181373OtherANTHEM
VA181373OtherANTHEM