NPIMap

Organization Active NPI

Fairfield Psychological Assoc.

  • Mental Health Counselor
  • Virginia Beach, VA
National Provider Identifier
1801068606
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0904000552 Issued in VA
Legal business name
FAIRFIELD PSYCHOLOGICAL ASSOC.
Practice address
5265 Providence Rd
Suite 500
Virginia Beach, VA 23464-4206
Phone
(757) 467-9500
Fax
(757) 467-9560
NPI assigned
Apr 1, 2008
Last updated
Apr 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Authorized official

Name
Mr. Gary Rotfus, LCSWNPI 1437206521
Title
President
Phone
(757) 467-9500

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 0904000552 VA Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 0904000552 VA

Addresses

Primary practice location

5265 Providence Rd
Suite 500
Virginia Beach, VA 23464-4206

Mailing address

5265 Providence Rd
Suite 500
Virginia Beach, VA 23464-4206
Phone (757) 467-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050727000938 VA Part B Supplier - Clinic/Group Practice 0244268654 Receives reassigned benefits from 16 practitioners
Practice locations: Virginia BCH, VA

National Provider Directory

National Provider Directory

Locations

5265 Providence Rd
Ste 500
Virginia Beach, VA 23464
Phone (757) 354-5379

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1801068606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5265 PROVIDENCE RD",
            "address_2": "SUITE 500",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644206",
            "telephone_number": "757-467-9500",
            "fax_number": "757-467-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5265 PROVIDENCE RD",
            "address_2": "SUITE 500",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644206",
            "telephone_number": "757-467-9500",
            "fax_number": "757-467-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFIELD PSYCHOLOGICAL ASSOC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "ROTFUS",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-467-9500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904000552",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904000552",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Apr 1, 2008; 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.