Provider Demographics
NPI:1598737496
Name:SUGDEN, THOMAS ANDREW (PSYD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ANDREW
Last Name:SUGDEN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3419 VIRGINIA BEACH BLVD # 800
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4419
Mailing Address - Country:US
Mailing Address - Phone:757-714-1838
Mailing Address - Fax:757-321-6269
Practice Address - Street 1:228 N LYNNHAVEN RD STE 110
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7514
Practice Address - Country:US
Practice Address - Phone:757-201-2927
Practice Address - Fax:757-321-6269
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003305103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0100358G8Medicaid
279306OtherANTHEM PPO
279306OtherBCBS
573544OtherMAGELLAN
C01884OtherMCARE GROUP #
279306OtherANTHEM HEALTHKEEPERS
085989MOtherSENTARA OPTIMA
234201OtherCOMPSYCH
2114650OtherMAMSI
2114650OtherMAMSI
279306OtherANTHEM HEALTHKEEPERS