Provider Demographics
NPI:1871649111
Name:HYMAN, JOSEPH ARTHUR (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ARTHUR
Last Name:HYMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12050 S LAKES DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1220
Mailing Address - Country:US
Mailing Address - Phone:703-476-5793
Mailing Address - Fax:703-620-2787
Practice Address - Street 1:12050 S LAKES DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1220
Practice Address - Country:US
Practice Address - Phone:703-476-5793
Practice Address - Fax:703-620-2787
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810000597103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA120465OtherVALUE OPTIONS
VA6297OtherCARE FIRST
VA017502OtherANTHEM
VA120465OtherTRICARE
VA192352OtherMHN