Individual provider Active NPI

Errol E Liebowitz, PHD

  • Clinical Psychologist
  • Virginia Beach, VA
National Provider Identifier
1457304115
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810001135 Issued in VA
Practice address
780 Lynnhaven Pkwy
Suite 340
Virginia Beach, VA 23452-7332
Phone
(757) 498-9585
Fax
(757) 468-1685
NPI assigned
May 17, 2006
Last updated
Sep 24, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810001135 VA Primary

Addresses

Primary practice location

780 Lynnhaven Pkwy
Suite 340
Virginia Beach, VA 23452-7332

Mailing address

780 Lynnhaven Pkwy
Suite 340
Virginia Beach, VA 23452-7332
Phone (757) 498-9585

Other identifiers 1

IdentifierTypeStateIssuer
7706201MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090624000092 VA Practitioner - Clinical Psychologist 0345391876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Ohio Medical University, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

333 Kellam Rd
Suite 100
Virginia Beach, VA 23462-2746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810001135VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Virginia Psychological Associates Clinical CurrentSince Oct 28, 2017 Accepting new patients
Errol Liebowitz PHD Clinical PastSince Jan 1, 1990 Accepting new patients
Spineworks Physical Therapy LLC Past Accepting new patients

Locations

333 Kellam Rd
Ste 100
Virginia Beach, VA 23462
Phone (757) 499-1694

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1457304115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 LYNNHAVEN PKWY",
            "address_2": "SUITE 340",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527332",
            "telephone_number": "757-498-9585",
            "fax_number": "757-468-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 LYNNHAVEN PKWY",
            "address_2": "SUITE 340",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527332",
            "telephone_number": "757-498-9585",
            "fax_number": "757-468-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBOWITZ",
        "first_name": "ERROL",
        "middle_name": "E",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7706201",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.