1972678464 NPI number — THE PSYCHOTHERAPY CENTER SOLUTIONS FOR LIVING LTD

Table of content: DR. JAMES MATTHEW MASSEY M.D., PH.D. (NPI 1083865976)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972678464 NPI number — THE PSYCHOTHERAPY CENTER SOLUTIONS FOR LIVING LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE PSYCHOTHERAPY CENTER SOLUTIONS FOR LIVING LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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 Information

NPI Number:
1972678464
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
327 W 21ST ST
Provider Second Line Business Mailing Address:
205
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23517-2130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-622-9852
Provider Business Mailing Address Fax Number:
757-622-4033

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
327 W 21ST ST
Provider Second Line Business Practice Location Address:
205
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23517-2130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-622-9852
Provider Business Practice Location Address Fax Number:
757-622-4033
Provider Enumeration Date:
11/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RABINOWITZ
Authorized Official First Name:
MARC
Authorized Official Middle Name:
D
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
757-622-9852

Provider Taxonomy Codes

  • Taxonomy code: 103TP2701X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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