| Affiliated Clinical Therapists | |
|
142 W York St Suite 710 Norfolk VA 23510-2015 | |
| (757) 623-2228 | |
| (757) 623-7186 |
| Full Name | Affiliated Clinical Therapists |
|---|---|
| Speciality | Psychologist |
| Location | 142 W York St, Norfolk, Virginia |
| Authorized Official Name and Position | Lawrence M Ross (OWNER) |
| Authorized Official Contact | 7576232228 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Affiliated Clinical Therapists 142 W York St Suite 710 Norfolk VA 23510-2015 Ph: (757) 623-2228 | Affiliated Clinical Therapists 142 W York St Suite 710 Norfolk VA 23510-2015 Ph: (757) 623-2228 |
| NPI Number | 1467671446 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1052412590 |
|---|---|
| Medicare Enrollment ID | O20070727000113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467671446 | NPI | - | NPPES |
| 7728476 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0810001655 (Virginia) | Primary |
| Provider Name | Lawrence Ross |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1811905250 PECOS PAC ID: 3678674116 Enrollment ID: I20120515000149 |
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