Provider Demographics
NPI:1013052927
Name:RESTON PSYCHOLOGICAL CENTER, P.C.
Entity Type:Organization
Organization Name:RESTON PSYCHOLOGICAL CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-437-3236
Mailing Address - Street 1:1800 TOWN CENTER DR
Mailing Address - Street 2:SUITE 411
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3215
Mailing Address - Country:US
Mailing Address - Phone:703-437-3236
Mailing Address - Fax:703-435-7422
Practice Address - Street 1:1800 TOWN CENTER DR
Practice Address - Street 2:SUITE 411
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3215
Practice Address - Country:US
Practice Address - Phone:703-437-3236
Practice Address - Fax:703-435-7422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA351885OtherNCPPO
VA071019OtherANTHEM BCBS
VA071019OtherANTHEM BCBS