NPIMap

Organization Active NPI

Psychological and Life Skills Associates, P.C.

  • Psychologist
  • Woodbridge, VA
National Provider Identifier
1619066727
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PSYCHOLOGICAL AND LIFE SKILLS ASSOCIATES, P.C.
Practice address
13885 Hedgewood Dr Ste 245
Psychological and Life Skills Associates, P.C.
Woodbridge, VA 22193-7931
Phone
(703) 490-0336
Fax
(703) 490-4525
NPI assigned
Oct 12, 2006
Last updated
Sep 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Authorized official

Name
Christopher T Haley, PSY DNPI 1215035183
Title
President
Phone
(703) 490-0336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

13885 Hedgewood Dr Ste 245
Psychological and Life Skills Associates, P.C.
Woodbridge, VA 22193-7931

Mailing address

13885 Hedgewood Dr Ste 245
Psychological and Life Skills Associates, P.C.
Woodbridge, VA 22193-7931
Phone (703) 490-0336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040428001567 VA Part B Supplier - Clinic/Group Practice 4688661838 Receives reassigned benefits from 11 practitioners
Practice locations: Fredericksburg, VA; Woodbridge, VA; Oakton, VA

National Provider Directory

National Provider Directory
Tax ID family
Psychological and Life Skills Associates PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2217 Princess Anne St
Ste 106-1
Fredericksburg, VA 22401
Phone (703) 490-0336

601 Emancipation Hwy
Ste 101
Fredericksburg, VA 22401
Phone (703) 490-0336

13885 Hedgewood Dr
Ste 245
Woodbridge, VA 22193
Phone (703) 490-0336

2239 Tacketts Mill Dr
#F
Woodbridge, VA 22192
Phone (703) 490-0336

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474243200000",
    "number": "1619066727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13885 HEDGEWOOD DR STE 245",
            "address_2": "PSYCHOLOGICAL AND LIFE SKILLS ASSOCIATES, P.C.",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221937931",
            "telephone_number": "703-490-0336",
            "fax_number": "703-490-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13885 HEDGEWOOD DR STE 245",
            "address_2": "PSYCHOLOGICAL AND LIFE SKILLS ASSOCIATES, P.C.",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221937931",
            "telephone_number": "703-490-0336",
            "fax_number": "703-490-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL AND LIFE SKILLS ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2016-09-19",
        "status": "A",
        "authorized_official_last_name": "HALEY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-490-0336",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.