1477535748 NPI number — DR. CAROL THOMASON PRITCHARD I PSY.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477535748 NPI number — DR. CAROL THOMASON PRITCHARD I PSY.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

PRITCHARD

Provider First Name:

CAROL

Provider Middle Name:

THOMASON

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

I

Provider Credential Text:

PSY.D.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1477535748

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/08/2007

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

219 43RD ST

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

VIRGINIA BEACH

Provider Business Mailing Address State Name:

VA

Provider Business Mailing Address Postal Code:

23451-2503

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

757-437-0000

Provider Business Mailing Address Fax Number:

757-422-2842

Provider First Line Business Practice Location Address:

219 43RD ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

VIRGINIA BEACH

Provider Business Practice Location Address State Name:

VA

Provider Business Practice Location Address Postal Code:

23451-2503

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

757-437-0000

Provider Business Practice Location Address Fax Number:

757-422-2842

Provider Enumeration Date:

11/14/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 103TC0700X , with the licence number:  0810001542 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 133041 . This is a "MANAGED HEALTH NETWORK" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
• Identifier: 133041 . This is a "HEALTHNET" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
• Identifier: 7707673 . This is a "VIRGINIA PREMIER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
• Identifier: 140003 . This is a "ANTHEM HEALTHKEEPERS PLUS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
• Identifier: 085342 . This is a "OPTIMA HEALTHCARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
• Identifier: 343796 . This is a "MDIPA" identifier . This identifiers is of the category "OTHER".
• Identifier: 89366 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
• Identifier: 6000620 . This is a "MEDICAID" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
• Identifier: 021770 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
• Identifier: 461121 . This is a "ANTHEM BLUECROSSBLUESHIEL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
• Identifier: 5526268 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".