Provider Demographics
NPI:1134283310
Name:PSYCHIATRIC SERVICES, P.C.
Entity type:Organization
Organization Name:PSYCHIATRIC SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-425-5050
Mailing Address - Street 1:1630 DONNA DR STE 102
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6188
Mailing Address - Country:US
Mailing Address - Phone:757-425-5050
Mailing Address - Fax:757-425-1389
Practice Address - Street 1:1630 DONNA DR STE 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6188
Practice Address - Country:US
Practice Address - Phone:757-425-5050
Practice Address - Fax:757-425-1389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101032227103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904001935Medicaid
VA0904001935Medicaid
VA004099P99Medicare ID - Type Unspecified
VA005027P99Medicare ID - Type Unspecified
VA009536P99Medicare ID - Type Unspecified