Robert Anthony Rella, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810005113 Issued in VA

Practice address

240 Business Park Dr
Suite 100
Virginia Beach, VA 23462-6521

Phone

(757) 497-3670

Fax

(757) 499-1947

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tidewater Psychotherapy Services

  • Addiction (Substance Use Disorder) Counselor
  • Virginia Beach, VA
  • NPI 1164536496
  NPD

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1841341963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 BUSINESS PARK DR",
            "address_2": "SUITE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626521",
            "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": "240 BUSINESS PARK DR",
            "address_2": "SUITE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626521",
            "telephone_number": "757-497-3670",
            "fax_number": "757-499-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RELLA",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3136",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Virginia Beach, VA
• Providers in Virginia Beach, 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 6, 2015; 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.