| Mcphatter Psychological Services, Pllc | |
|
4445 Corporation Ln Ste 272 Virginia Beach VA 23462-3262 | |
| (757) 231-6835 | |
| (757) 456-1121 |
| Full Name | Mcphatter Psychological Services, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4445 Corporation Ln Ste 272, Virginia Beach, Virginia |
| Authorized Official Name and Position | E Annette Mcphatter (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 6313343341 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcphatter Psychological Services, Pllc Po Box 66384 Virginia Beach VA 23466-6384 Ph: () - | Mcphatter Psychological Services, Pllc 4445 Corporation Ln Ste 272 Virginia Beach VA 23462-3262 Ph: (757) 231-6835 |
| NPI Number | 1235723578 |
|---|---|
| Provider Enumeration Date | 02/26/2021 |
| Last Update Date | 03/09/2021 |
| Certification Date | 03/09/2021 |
| Medicare PECOS PAC ID | 1456759984 |
|---|---|
| Medicare Enrollment ID | O20211013001359 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235723578 | NPI | - | NPPES |
| 1720091259 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Ernestine Annette Mcphatter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720091259 PECOS PAC ID: 5193961563 Enrollment ID: I20130410000262 |
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