NPIMap

Organization Active NPI

Chase Psychological Resources, Inc.

  • Clinical Psychologist
  • Fairfax, VA
National Provider Identifier
1063696466
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810002159 Issued in VA
Legal business name
CHASE PSYCHOLOGICAL RESOURCES, INC.
Practice address
10721 Main St
Suite 2350
Fairfax, VA 22030-6914
Phone
(703) 591-5912
Fax
(703) 591-7210
NPI assigned
Dec 20, 2007
Last updated
Dec 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Lee R Chase, PH.D.NPI 1861493520
Title
Psychologist/President
Phone
(301) 325-5043

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 03341 MD
Clinical Psychologist 103TC0700X 0810002159 VA Primary

Addresses

Primary practice location

10721 Main St
Suite 2350
Fairfax, VA 22030-6914

Mailing address

327 Chestertown St
Gaithersburg, MD 20878-5686
Phone (301) 325-5043

Other identifiers 2

IdentifierTypeStateIssuer
1588702047OtherMDNPI
1861493520OtherMDNPI

National Provider Directory

National Provider Directory

Locations

10721 Main St
Ste 2350
Fairfax, VA 22030
Phone (703) 591-5912

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1063696466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 CHESTERTOWN ST",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785686",
            "telephone_number": "301-325-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST",
            "address_2": "SUITE 2350",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306914",
            "telephone_number": "703-591-5912",
            "fax_number": "703-591-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHASE PSYCHOLOGICAL RESOURCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "CHASE",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PSYCHOLOGIST/PRESIDENT",
        "authorized_official_telephone_number": "301-325-5043",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "03341",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1588702047",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1861493520",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.