Provider Demographics
NPI:1245622638
Name:IN FAITH PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:IN FAITH PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JANEL
Authorized Official - Middle Name:ELITA
Authorized Official - Last Name:PLEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:757-729-2549
Mailing Address - Street 1:1508 SAMS CIR
Mailing Address - Street 2:PMB 138
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4589
Mailing Address - Country:US
Mailing Address - Phone:757-729-2549
Mailing Address - Fax:
Practice Address - Street 1:1508 SAMS CIR
Practice Address - Street 2:PMB 138
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4589
Practice Address - Country:US
Practice Address - Phone:757-729-2549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003792103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAQ47030AMedicare PIN