Provider Demographics
NPI:1851992333
Name:BEACH NEUROPSYCHOLOGY SERVICES LLC
Entity Type:Organization
Organization Name:BEACH NEUROPSYCHOLOGY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGIN MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:JANETTE
Authorized Official - Last Name:SARI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:757-373-0614
Mailing Address - Street 1:317 OFFICE SQUARE LN STE B102
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3650
Mailing Address - Country:US
Mailing Address - Phone:757-703-7708
Mailing Address - Fax:757-732-0953
Practice Address - Street 1:317 OFFICE SQUARE LN STE B102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3650
Practice Address - Country:US
Practice Address - Phone:757-703-7708
Practice Address - Fax:757-732-0953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-03
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty