NPIMap

Organization Active NPI

Psychological and Life Skills Association

  • Clinical Social Worker
  • Fredericksburg, VA
National Provider Identifier
1992164834
Registry record updated Feb 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904009260 Issued in VA
Legal business name
PSYCHOLOGICAL AND LIFE SKILLS ASSOCIATION
Practice address
601 Jefferson Davis Hwy
Suite 101
Fredericksburg, VA 22401-4564
Phone
(703) 490-0336
NPI assigned
Feb 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2016

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

Authorized official

Name
Elizabeth Yarborough Taft, LCSW
Title
Clinical Social Worker
Phone
(571) 285-1403

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 0904009260 VA Primary

Addresses

Primary practice location

601 Jefferson Davis Hwy
Suite 101
Fredericksburg, VA 22401-4564

Mailing address

601 Jefferson Davis Hwy
Suite 101
Fredericksburg, VA 22401-4564
Phone (703) 490-0336

National Provider Directory

National Provider Directory
Tax ID family
Psychological and Life Skills Associates PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1456012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456012800000",
    "number": "1992164834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JEFFERSON DAVIS HWY",
            "address_2": "SUITE 101",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014564",
            "telephone_number": "703-490-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JEFFERSON DAVIS HWY",
            "address_2": "SUITE 101",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014564",
            "telephone_number": "703-490-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL AND LIFE SKILLS ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-21",
        "last_updated": "2016-02-21",
        "status": "A",
        "authorized_official_last_name": "TAFT",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "YARBOROUGH",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "571-285-1403",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2016; 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.