| Four Rivers Psychological Services, Llc | |
|
615 Jefferson Davis Hwy Ste 202 Fredericksburg VA 22401-8407 | |
| (540) 300-7004 | |
| Not Available |
| Full Name | Four Rivers Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 615 Jefferson Davis Hwy Ste 202, Fredericksburg, Virginia |
| Authorized Official Name and Position | Patrice J Berry (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5403007004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Rivers Psychological Services, Llc 615 Jefferson Davis Hwy Ste 202 Fredericksburg VA 22401-8407 Ph: (757) 810-0655 | Four Rivers Psychological Services, Llc 615 Jefferson Davis Hwy Ste 202 Fredericksburg VA 22401-8407 Ph: (540) 300-7004 |
| NPI Number | 1093348591 |
|---|---|
| Provider Enumeration Date | 02/13/2020 |
| Last Update Date | 02/25/2020 |
| Certification Date | 02/25/2020 |
| Medicare PECOS PAC ID | 2668802307 |
|---|---|
| Medicare Enrollment ID | O20200421002933 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093348591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Patrice J Berry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790093961 PECOS PAC ID: 3577993211 Enrollment ID: I20200421002992 |
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