Provider Demographics
NPI:1689604027
Name:BILLUPS, ANDREW JACKSON III (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JACKSON
Last Name:BILLUPS
Suffix:III
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:48 SOUTH MAIN STREET
Mailing Address - Street 2:BOX 2234
Mailing Address - City:KILMARNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22482-2234
Mailing Address - Country:US
Mailing Address - Phone:804-435-6777
Mailing Address - Fax:804-435-6789
Practice Address - Street 1:48 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:KILMARNOCK
Practice Address - State:VA
Practice Address - Zip Code:22482-2234
Practice Address - Country:US
Practice Address - Phone:804-435-6777
Practice Address - Fax:804-435-6789
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001192103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical