Provider Demographics
NPI:1821298928
Name:OYSTER POINT PSYCHOLOGICAL, INC
Entity Type:Organization
Organization Name:OYSTER POINT PSYCHOLOGICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JACKSON
Authorized Official - Last Name:BILLUPS
Authorized Official - Suffix:III
Authorized Official - Credentials:PSYD
Authorized Official - Phone:804-435-6777
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:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001192103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty