Provider Demographics
NPI:1700858685
Name:EDWARDS, DEBORAH MICHELLE (PSY D)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:MICHELLE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 LYNNHAVEN PKWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7332
Mailing Address - Country:US
Mailing Address - Phone:757-468-0550
Mailing Address - Fax:757-468-9992
Practice Address - Street 1:780 LYNNHAVEN PKWY
Practice Address - Street 2:SUITE 400 ATLANTIC PSYCHIATRIC SERVICES
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7332
Practice Address - Country:US
Practice Address - Phone:757-468-0550
Practice Address - Fax:757-468-9992
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2108610OtherMAMSI
327267OtherMANAGED HEALTH NETWORK
223200OtherCOM PSYCH
588516OtherMAGELLAN
C01884OtherMCARE GROUP
081724MOtherSENTARA OPTIMA
246378OtherANTHEM PPO BCBS
081724MOtherSENTARA OPTIMA
P89365Medicare UPIN