Provider Demographics
NPI:1912009317
Name:PSYCHOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:PSYCHOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:540-672-0474
Mailing Address - Street 1:112 BELLEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:VA
Mailing Address - Zip Code:22960-1402
Mailing Address - Country:US
Mailing Address - Phone:540-672-0474
Mailing Address - Fax:540-672-3029
Practice Address - Street 1:112 BELLEVIEW AVENUE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:VA
Practice Address - Zip Code:22960
Practice Address - Country:US
Practice Address - Phone:540-672-0474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA075103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004947487Medicaid
VA004947487Medicaid