Evolution Psychological Services, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810004799 Issued in VA

Legal business name

EVOLUTION PSYCHOLOGICAL SERVICES, PC

Practice address

13885 Hedgewood Dr
Suite 349
Woodbridge, VA 22193-7928

Phone

(703) 317-7271

NPI assigned

Jan 14, 2017

Organization subpart

No

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

Authorized official

Name

Reginald Henry McRae, PSYD

Title

Chief Executive Officer

Phone

(703) 317-7271

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1484352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484352000000",
    "number": "1679019608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2465 DONNINGTON CT",
            "city": "JEFFERSONTON",
            "state": "VA",
            "postal_code": "227241730",
            "telephone_number": "540-937-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13885 HEDGEWOOD DR",
            "address_2": "SUITE 349",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221937928",
            "telephone_number": "703-317-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION PSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-14",
        "last_updated": "2017-01-14",
        "status": "A",
        "authorized_official_last_name": "MCRAE",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "703-317-7271",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eveready Residential Support Services
• Evergreen Equipment Supplies LLC
• Evergreen Healthcare LLC
• Susan Jane Evers, BCBA
• Everyblessing Healthcare
• Evolve Physical Therapy LLC
• Excel Medical Clinic, Inc.
• Excellent Care Home Health Services LLC
• Excellent Health Care Services Inc.
• Exceptional Matters

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2017; 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.