Provider Demographics
NPI:1891897203
Name:NAGEL, JOSEPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:NAGEL
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 1:112 BELLEVIEW AVENUE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:VA
Mailing Address - Zip Code:22960
Mailing Address - Country:US
Mailing Address - Phone:540-672-0474
Mailing Address - Fax:540-672-3029
Practice Address - Street 1:112 BELLEVIEW AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:VA
Practice Address - Zip Code:22960-1402
Practice Address - Country:US
Practice Address - Phone:540-672-0474
Practice Address - Fax:540-672-3029
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001423103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA018876OtherVALUE OPTIONS
VA058364OtherANTHEM
VA7730357Medicaid
VA254505000OtherMAGELLAN
VA083057OtherSENTARA
VA282456OtherMAMSI
VA018876OtherVALUE OPTIONS