| Loudoun Psychological Services | |
|
217 S King St Leesburg VA 20175-2905 | |
| (703) 297-4368 | |
| (571) 512-7955 |
| Full Name | Loudoun Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 217 S King St, Leesburg, Virginia |
| Authorized Official Name and Position | Eric Zelsdorf (CHIEF CLINICAL OFFICER) |
| Authorized Official Contact | 7032974368 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Loudoun Psychological Services 217 S King St Leesburg VA 20175-2905 Ph: () - | Loudoun Psychological Services 217 S King St Leesburg VA 20175-2905 Ph: (703) 297-4368 |
| NPI Number | 1427422385 |
|---|---|
| Provider Enumeration Date | 11/16/2015 |
| Last Update Date | 12/05/2018 |
| Medicare PECOS PAC ID | 4486959889 |
|---|---|
| Medicare Enrollment ID | O20160223001511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427422385 | NPI | - | NPPES |
| 1679600266 | Other | NPI | |
| 601050065 | Medicaid | VA | |
| 600961320 | Medicaid | VA | |
| 1104228121 | Other | NPI | |
| 1417312257 | Other | NPI | |
| 601076584 | Medicaid | VA | |
| 601119488 | Medicaid | VA | |
| 1275810764 | Other | NPI | |
| 1902353360 | Other | NPI | |
| 1194910562 | Other | VA | NPI |
| 1457808818 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 0810005246 (Virginia) | Primary |
| Provider Name | Donald C Jaskulske |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679600266 PECOS PAC ID: 4486809142 Enrollment ID: I20130301000370 |
| Provider Name | Eric D Zelsdorf |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255765293 PECOS PAC ID: 0648575043 Enrollment ID: I20160223001799 |
| Provider Name | Najwa Mohamed |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457808818 PECOS PAC ID: 2264779594 Enrollment ID: I20190124002809 |
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