NPIMap

Organization Active NPI

360 Pyschological Services

  • Psychologist
  • Fredericksburg, VA
National Provider Identifier
1790802478
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0810002447 Issued in VA
Legal business name
360 PYSCHOLOGICAL SERVICES
Practice address
1133 Heatherstone Dr Ste 102
Fredericksburg, VA 22407-4828
Phone
(540) 702-8573
NPI assigned
Mar 26, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Thomas X Joseph, PHDNPI 1801833116
Title
Owner
Phone
(540) 702-8573

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

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070511000293 VA Part B Supplier - Clinic/Group Practice 8325144116 Receives reassigned benefits from 1 practitioner
Practice locations: Fredericksburg, VA

National Provider Directory

Locations

1133 Heatherstone Dr
#102
Fredericksburg, VA 22407
Phone (540) 548-2430

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 0810002447 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

1133 Heatherstone Dr Ste 102
Fredericksburg, VA 22407-4828

Mailing address

1133 Heatherstone Dr Ste 102
Fredericksburg, VA 22407-4828
Phone (540) 702-8573

Other names 1

NPPES NPI Registry
  • Thomas X Joseph Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 29, 2022.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1790802478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 HEATHERSTONE DR STE 102",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074828",
            "telephone_number": "540-702-8573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 HEATHERSTONE DR STE 102",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074828",
            "telephone_number": "540-702-8573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 PYSCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "X",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-702-8573",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810002447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thomas X Joseph",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.