Individual provider Active NPI

Robert Joel Seltzer, PH D

  • Psychologist
  • Norfolk, VA
National Provider Identifier
1154340354
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0810000886 Issued in VA
Practice address
6353 Center Drive
Ste 204
Norfolk, VA 23502
Phone
(757) 461-3313
Fax
(757) 461-8363
NPI assigned
Jul 19, 2006
Last updated
Nov 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0810000886 VA Primary
Clinical Psychologist 103TC0700X 0810000886 VA
Clinical Child & Adolescent Psychologist 103TC2200X 0810000886 VA

Addresses

Primary practice location

6353 Center Drive
Ste 204
Norfolk, VA 23502

Mailing address

6353 Center Drive
Ste 204
Norfolk, VA 23502
Phone (757) 461-3313

Other identifiers 1

IdentifierTypeStateIssuer
007733453MedicaidVA

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
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321920000000",
    "number": "1154340354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6353 CENTER DRIVE",
            "address_2": "STE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23502",
            "telephone_number": "757-461-3313",
            "fax_number": "757-461-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6353 CENTER DRIVE",
            "address_2": "STE 204",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23502",
            "telephone_number": "757-461-3313",
            "fax_number": "757-461-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELTZER",
        "first_name": "ROBERT",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "PH D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810000886",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810000886",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VA",
            "license": "0810000886",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007733453",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; 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.