Provider Demographics
NPI:1881757797
Name:GERBRACHT, TIMOTHY ROBERT (PSYD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ROBERT
Last Name:GERBRACHT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 PARK WASHINGTON CT
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4519
Mailing Address - Country:US
Mailing Address - Phone:703-533-5825
Mailing Address - Fax:703-533-8431
Practice Address - Street 1:109 PARK WASHINGTON CT
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4519
Practice Address - Country:US
Practice Address - Phone:703-533-5825
Practice Address - Fax:703-533-8431
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003745103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical