| Clinical Associates Of Tidewater | |
|
12695 Mcmanus Blvd Bldg 8 Newport News VA 23602-4442 | |
| (757) 877-7700 | |
| (757) 872-7211 |
| Full Name | Clinical Associates Of Tidewater |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 12695 Mcmanus Blvd Bldg 8, Newport News, Virginia |
| Authorized Official Name and Position | Naomi S Goldblum (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7578777700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical Associates Of Tidewater 12695 Mcmanus Blvd Bldg 8 Newport News VA 23602-4442 Ph: (757) 877-7700 | Clinical Associates Of Tidewater 12695 Mcmanus Blvd Bldg 8 Newport News VA 23602-4442 Ph: (757) 877-7700 |
| NPI Number | 1447341615 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4981688744 |
|---|---|
| Medicare Enrollment ID | O20040617001131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447341615 | NPI | - | NPPES |
| Provider Name | David L Deaver |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891708160 PECOS PAC ID: 0840250502 Enrollment ID: I20041016000127 |
| Provider Name | Rebecca W Keller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437174067 PECOS PAC ID: 2062457369 Enrollment ID: I20050627001353 |
| Provider Name | Catherine I Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457426769 PECOS PAC ID: 3870567522 Enrollment ID: I20090910000682 |
| Provider Name | Naomi Sara Goldblum |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942225008 PECOS PAC ID: 3375527146 Enrollment ID: I20100928000742 |
| Provider Name | Howard J Bierenbaum |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639277395 PECOS PAC ID: 0143401778 Enrollment ID: I20110302000056 |
| Provider Name | John Havrilla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053409433 PECOS PAC ID: 7618159237 Enrollment ID: I20110303000122 |
| Provider Name | Fredrick P Frieden |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316035975 PECOS PAC ID: 0446432330 Enrollment ID: I20110314001084 |
| Provider Name | Alison Mascalo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083790380 PECOS PAC ID: 3274716378 Enrollment ID: I20110328000549 |
| Provider Name | Cathy G Cooke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588063663 PECOS PAC ID: 6901122647 Enrollment ID: I20150224001037 |
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