Individual provider Active NPI

Robert Daniel, PH.D

  • Psychologist
  • Virginia Beach, VA
National Provider Identifier
1649253774
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0810001557 Issued in VA
Practice address
256 N Witchduck Rd
Suite G
Virginia Beach, VA 23462-6544
Phone
(757) 497-3670
Fax
(757) 499-1947
NPI assigned
Nov 22, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0810001557 VA Primary

Addresses

Primary practice location

256 N Witchduck Rd
Suite G
Virginia Beach, VA 23462-6544

Mailing address

256 N Witchduck Rd
Suite G
Virginia Beach, VA 23462-6544
Phone (757) 497-3670

Other identifiers 1

IdentifierTypeStateIssuer
7753021MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0810001557VAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Psychotherapy Services CurrentSince Jul 24, 2022 Accepting new patients

Locations

260 Grayson Rd
Ste 100
Virginia Beach, VA 23462
Phone (757) 497-3670

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1649253774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 N WITCHDUCK RD",
            "address_2": "SUITE G",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626544",
            "telephone_number": "757-497-3670",
            "fax_number": "757-499-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 N WITCHDUCK RD",
            "address_2": "SUITE G",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626544",
            "telephone_number": "757-497-3670",
            "fax_number": "757-499-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "ROBERT",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810001557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7753021",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.