Provider Demographics
NPI:1962440495
Name:VIRGINIA PSYCHOLOGICAL SERVICES PLC
Entity Type:Organization
Organization Name:VIRGINIA PSYCHOLOGICAL SERVICES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCOLOGIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:LINDEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:757-873-4744
Mailing Address - Street 1:PO BOX 12225
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23612-2225
Mailing Address - Country:US
Mailing Address - Phone:757-873-4744
Mailing Address - Fax:757-873-6377
Practice Address - Street 1:732 THIMBLE SHOALS BLVD STE 705K
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4256
Practice Address - Country:US
Practice Address - Phone:757-873-4744
Practice Address - Fax:757-873-6377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007714424Medicaid
VAC08954Medicare UPIN