Organization Active NPI

Neuropsych Roanoke LLC

  • Clinical Psychologist
  • Roanoke, VA
National Provider Identifier
1942187430
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
NEUROPSYCH ROANOKE LLC
Practice address
3390 Colonial Ave
Roanoke, VA 24018-3740
Phone
(757) 383-5456
NPI assigned
Aug 18, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Authorized official

Name
Ella H PecsokNPI 1780695064
Title
Owner
Phone
(757) 383-5456

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 1

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

Addresses

Primary practice location

3390 Colonial Ave
Roanoke, VA 24018-3740

Mailing address

3205 Northshire CT
Roanoke, VA 24014-1102

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251015004285 VA Part B Supplier - Clinic/Group Practice 3375030042 Receives reassigned benefits from 1 practitioner
Practice locations: Roanoke, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1942187430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 NORTHSHIRE CT",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 COLONIAL AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183740",
            "telephone_number": "757-383-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPSYCH ROANOKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "PECSOK",
        "authorized_official_first_name": "ELLA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-383-5456"
    },
    "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 Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.