Lakeside Psychological Center Pc

LBN: Lakeside Psychological Center Pc
Lakeside Psychological Center Pc is an health care organization with primary practice located at 3076 Brickhouse Ct , Virginia Beach VA 23452-6859. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as the primary health care specialty. Lakeside Psychological Center Pc can be contacted via phone (757) 486-0909, or through Stevens, Theodore M via phone (757) 486-0909.

Contact Information

Primary practice address
3076 Brickhouse Ct Virginia Beach VA 23452-6859
Phone: (757) 486-0909
Fax: (757) 340-7518
Website:
Map and Directions
Authorized official contact:
Name: Stevens, Theodore M PHD
Phone: (757) 486-0909

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 90801000970 Virginia

Profile Details

NPI number 1104044528
LBN Legal business name Lakeside Psychological Center Pc
DBA Doing business as
Authorized official Stevens, Theodore M PHD
Entity Organization
Organization subpart 1 No
Enumeration date Apr 23rd, 2007
Last updated Sep 1st, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104044528 NPPES
Virginia Other 1790811040 NPI
Virginia Other 1104044528 NPI

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