Provider Demographics
NPI:1649280249
Name:ROY, LOUISE GABRIELLE (PHD)
Entity type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:GABRIELLE
Last Name:ROY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 W. GREAT FALLS ST.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3402
Mailing Address - Country:US
Mailing Address - Phone:703-798-5186
Mailing Address - Fax:301-576-5173
Practice Address - Street 1:131 W. GREAT FALLS ST.
Practice Address - Street 2:SUITE 101
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3402
Practice Address - Country:US
Practice Address - Phone:703-798-5186
Practice Address - Fax:202-558-2157
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY 1689103TC0700X
VA0810002170103TC0700X
VA0810-002170103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA620005959OtherRAILROAD MEDICARE
DC620005959OtherRAILROAD MEDICARE
DC620005959OtherRAILROAD MEDICARE
819012Medicare UPIN
813522Medicare UPIN
VAR0819012Medicare ID - Type Unspecified