Psychological Services of Virginia

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

Legal business name

PSYCHOLOGICAL SERVICES OF VIRGINIA

Practice address

645 Church St Ste 205
Norfolk, VA 23510-1712

Phone

(757) 309-4688

NPI assigned

Sep 12, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Laconda Fanning, PSY-D

Title

Director

Phone

(757) 235-3751

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1205261963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 CHURCH ST STE 205",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101712",
            "telephone_number": "757-309-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 CHURCH ST STE 205",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101712",
            "telephone_number": "757-309-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL SERVICES OF VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-12",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "FANNING",
        "authorized_official_first_name": "LACONDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "757-235-3751",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY-D"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Group Psychotherapy Psychologist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Group Psychotherapy Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.