Individual provider Active NPI

Laura Caccavale, PHD

  • Clinical Psychologist
  • Richmond, VA
National Provider Identifier
1568865681
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810006062 Issued in VA
Practice address
2303 N Parham Rd
Richmond, VA 23229-3102
Phone
(804) 527-4782
NPI assigned
Oct 2, 2014
Last updated
Jan 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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 0810006062 VA Primary

Addresses

Primary practice location

2303 N Parham Rd
Richmond, VA 23229-3102

Mailing address

2303 N Parham Rd
Henrico, VA 23229-3102
Phone (804) 527-4782

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
I20210505001846 VA Practitioner - Clinical Psychologist 0648689547 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Mar 1, 2021 Accepting new patients

Locations

2305 N Parham Rd
Ste 1
Richmond, VA 23229
Phone (804) 527-4716

2305 N Parham Rd
Richmond, VA 23229
Phone (804) 346-3077

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

Organizations & group practices 1

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": "1412208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1568865681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2303 N PARHAM RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232293102",
            "telephone_number": "804-527-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 N PARHAM RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232293102",
            "telephone_number": "804-527-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACCAVALE",
        "first_name": "LAURA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-02",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810006062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.