NPIMap

Organization Active NPI

Old Dominion University

  • Clinical Psychologist
  • Norfolk, VA
National Provider Identifier
1881518645
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
OLD DOMINION UNIVERSITY
Practice address
1074 47TH St
Norfolk, VA 23508-1910
Phone
(757) 683-6988
NPI assigned
Aug 5, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Authorized official

Name
Peter Anthony Mollica
Title
HS Medical Diagnostic and Translati
Phone
(757) 683-3459

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

1074 47TH St
Norfolk, VA 23508-1910

Mailing address

1074 47TH St
Norfolk, VA 23508-1910

National Provider Directory

National Provider Directory
Tax ID family
Old Dominion University4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1074 47th St
Norfolk, VA 23508

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1785888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785888000000",
    "number": "1881518645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1074 47TH ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235081910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1074 47TH ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235081910",
            "telephone_number": "757-683-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD DOMINION UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-05",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A",
        "authorized_official_last_name": "MOLLICA",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "HS MEDICAL DIAGNOSTIC AND TRANSLATI",
        "authorized_official_telephone_number": "757-683-3459"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.