Provider Demographics
NPI:1619152741
Name:PATRICIA A ONDERCIN
Entity Type:Organization
Organization Name:PATRICIA A ONDERCIN
Other - Org Name:PSYCHOLOGICAL ASSOCIATES OF WILLIAMSBURG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ONDERCIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LCP
Authorized Official - Phone:757-253-1462
Mailing Address - Street 1:1313 JAMESTOWN ROAD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-3362
Mailing Address - Country:US
Mailing Address - Phone:757-253-1462
Mailing Address - Fax:757-253-8061
Practice Address - Street 1:1313 JAMESTOWN ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-3362
Practice Address - Country:US
Practice Address - Phone:757-253-1462
Practice Address - Fax:757-253-8061
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATRICIA A ONDERCIN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810000994103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC03286OtherMEDICARE GROUP