Organization Active NPI

Verdon PC

  • Clinical Psychologist
  • Virginia Beach, VA
National Provider Identifier
1942579693
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810002194 Issued in VA
Legal business name
VERDON PC
Practice address
3091 Brickhouse CT
Virginia Beach, VA 23452-6860
Phone
(757) 557-6328
NPI assigned
Dec 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

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

Authorized official

Name
Daniele P McNeill, PH.D.NPI 1396849337
Title
Owner
Phone
(757) 340-2712

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: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 0810002194 VA Primary

Addresses

Primary practice location

3091 Brickhouse CT
Virginia Beach, VA 23452-6860

Mailing address

729 Trio LN
Virginia Beach, VA 23452-5931
Phone (757) 340-2712

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200706000136 VA Part B Supplier - Clinic/Group Practice 1658536594 Receives reassigned benefits from 1 practitioner
Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory

Locations

3091 Brickhouse Ct
Virginia Beach, VA 23452
Phone (757) 271-3101

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": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324944000000",
    "number": "1942579693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 TRIO LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234525931",
            "telephone_number": "757-340-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3091 BRICKHOUSE CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234526860",
            "telephone_number": "757-557-6328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERDON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2011-12-27",
        "status": "A",
        "authorized_official_last_name": "MCNEILL",
        "authorized_official_first_name": "DANIELE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-340-2712",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002194",
            "primary": true
        }
    ],
    "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 Dec 27, 2011; 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.