Provider Demographics
NPI:1134185705
Name:ALPERIN, JODY E (PSYD)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:E
Last Name:ALPERIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 ARMISTEAD BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1036
Mailing Address - Country:US
Mailing Address - Phone:757-627-6714
Mailing Address - Fax:
Practice Address - Street 1:3210 CHURCHLAND BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5253
Practice Address - Country:US
Practice Address - Phone:757-483-3404
Practice Address - Fax:757-483-0461
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002417103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAANTHEMOther321048
VA7706600Medicaid