Lakeside Psychological Center Pc | |
3076 Brickhouse Ct Virginia Beach VA 23452-6859 | |
(757) 486-0909 | |
(757) 340-7518 |
Full Name | Lakeside Psychological Center Pc |
---|---|
Speciality | Psychologist |
Location | 3076 Brickhouse Ct, Virginia Beach, Virginia |
Authorized Official Name and Position | Theodore M Stevens (PRESIDENT, PSYCHOLOGIST) |
Authorized Official Contact | 7574860909 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Lakeside Psychological Center Pc 3076 Brickhouse Ct Virginia Beach VA 23452-6859 Ph: (757) 486-0909 | Lakeside Psychological Center Pc 3076 Brickhouse Ct Virginia Beach VA 23452-6859 Ph: (757) 486-0909 |
NPI Number | 1104044528 |
---|---|
Provider Enumeration Date | 04/23/2007 |
Last Update Date | 09/01/2010 |
Medicare PECOS PAC ID | 8022076660 |
---|---|
Medicare Enrollment ID | O20041229000182 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104044528 | NPI | - | NPPES |
1790811040 | Other | VA | NPI |
1104044528 | Other | VA | CORPORATE NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 90801000970 (Virginia) | Primary |
Provider Name | Theodore M Stevens |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1790824381 PECOS PAC ID: 7911021043 Enrollment ID: I20160127001963 |
Journey Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 N Lynnhaven Rd, Suite 201, Virginia Beach, VA 23452 Phone: 757-414-7072 | |
Applied Behavior Consulting, Llc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 704 Achilles Ct, Virginia Beach, VA 23464 Phone: 757-559-1123 | |
Bhg Xlii, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5715 Princess Anne Rd, Virginia Beach, VA 23462 Phone: 757-962-0748 | |
Seaside Aba Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3212 Lorton Ct, Virginia Beach, VA 23452 Phone: 757-575-6820 | |
A New Perspective Therapy Services, Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 101 N Lynnhaven Rd Ste 201, Virginia Beach, VA 23452 Phone: 805-704-1519 | |
Goodman Group Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 433 S Witchduck Rd, Virginia Beach, VA 23462 Phone: 757-613-6401 | |
Masterson Psychotherapy, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 4445 Corporation Ln Ste 213, Virginia Beach, VA 23462 Phone: 757-237-2906 Fax: 757-216-9655 |