| Thomas X Joseph | |
|
1133 Heatherstone Dr Ste 102 Fredericksburg VA 22407-4828 | |
| (540) 702-8573 | |
| Not Available |
| Full Name | Thomas X Joseph |
|---|---|
| Speciality | Psychologist |
| Location | 1133 Heatherstone Dr Ste 102, Fredericksburg, Virginia |
| Authorized Official Name and Position | Thomas X Joseph (OWNER) |
| Authorized Official Contact | 5407028573 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas X Joseph 1133 Heatherstone Dr Ste 102 Fredericksburg VA 22407-4828 Ph: (540) 702-8573 | Thomas X Joseph 1133 Heatherstone Dr Ste 102 Fredericksburg VA 22407-4828 Ph: (540) 702-8573 |
| NPI Number | 1790802478 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 11/29/2022 |
| Certification Date | 11/29/2022 |
| Medicare PECOS PAC ID | 8325144116 |
|---|---|
| Medicare Enrollment ID | O20070511000293 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790802478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 0810002447 (Virginia) | Primary |
| Provider Name | Thomas X Joseph |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801833116 PECOS PAC ID: 7315043106 Enrollment ID: I20230321000912 |
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