Peninsula Psychotherapy Center

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810004168 Issued in VA

Legal business name

PENINSULA PSYCHOTHERAPY CENTER

Practice address

306 High Point Rd
Williamsburg, VA 23185-5847

Phone

(757) 903-3284

NPI assigned

Oct 23, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Amaya A. Rucker, PSY.D., LCP

Title

Director

Phone

(757) 903-3284

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256256000000",
    "number": "1285960377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 HIGH POINT RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855847",
            "telephone_number": "757-903-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 HIGH POINT RD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855847",
            "telephone_number": "757-903-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA PSYCHOTHERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-23",
        "last_updated": "2009-10-23",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "AMAYA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "757-903-3284",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., LCP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2009; 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.