Provider Demographics
NPI:1922532001
Name:CEDAR PSYCHOLOGICAL CENTER
Entity Type:Organization
Organization Name:CEDAR PSYCHOLOGICAL CENTER
Other - Org Name:PARKER PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:540-326-8181
Mailing Address - Street 1:42450 FAWN MEADOW PL
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-4177
Mailing Address - Country:US
Mailing Address - Phone:540-326-8181
Mailing Address - Fax:540-326-8183
Practice Address - Street 1:115 THE PLAINS ROAD, SUITE 200
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:VA
Practice Address - Zip Code:20118-1240
Practice Address - Country:US
Practice Address - Phone:540-326-8181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004305103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty