Active NPI
Demetria C. Brown, PSY.D.
- Clinical Psychologist
- Chester, VA
National Provider Identifier
1003052457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810003970
- Practice address
- 11923 Centre St Ste A9
Chester, VA 23831-1702 - Phone
- (804) 861-6616
- NPI assigned
- Jan 6, 2009
- Last updated
- Jun 13, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810003970 | VA | Primary |
| Clinical Psychologist | 103TC0700X | 3835 | AZ |
Addresses
Primary practice location
11923 Centre St Ste A9
Chester, VA 23831-1702
Mailing address
11923 Centre St Ste A9
Chester, VA 23831-1702
Phone (804) 861-6616
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003052457 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3835 | AZ | MD | Clinical Psychologist |
| 0810003970 | VA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chapman Senior Care, Inc. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Richmond, VA
- NPI 1669439691
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339545600000",
"number": "1003052457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11923 CENTRE ST STE A9",
"city": "CHESTER",
"state": "VA",
"postal_code": "238311702",
"telephone_number": "804-861-6616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11923 CENTRE ST STE A9",
"city": "CHESTER",
"state": "VA",
"postal_code": "238311702",
"telephone_number": "804-861-6616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "DEMETRIA",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-06",
"last_updated": "2012-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810003970",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AZ",
"license": "3835",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1003052457",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chester, VA
- Brighter Days Mental Health Services (Bdmhs)
- Paul W Brinser III, DDS
- Diana W Brooks, DPT
- Brothers Healthgroup
- Bryanna Keishelle Brown, LCSW
- Elizabeth Brown, HAIR LOSS SPECIALIST
- Jessica Brown, DPT
- Candice Bruce, COTA/L
- Buddy Enterprizes, LLC (Grandbuddies HHCA, Companion Services, Medical Supplies)
- Building Bridges Therapeutic & Consulting Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.