Provider Demographics
NPI:1740363415
Name:NEUROPSYCHOLOGICAL AND PSYCHOLOGICAL SERVICES, P.C.
Entity type:Organization
Organization Name:NEUROPSYCHOLOGICAL AND PSYCHOLOGICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEC
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:LEBEDUN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-283-3325
Mailing Address - Street 1:600 CAMERON ST # 307
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2506
Mailing Address - Country:US
Mailing Address - Phone:703-283-3325
Mailing Address - Fax:571-418-0078
Practice Address - Street 1:600 CAMERON ST # 307
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2506
Practice Address - Country:US
Practice Address - Phone:703-283-3325
Practice Address - Fax:571-418-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001828103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB570OtherCARE FIRST BLUE CROSS
DCG01652Medicare PIN