Healthcare Provider Details

I. General information

NPI: 1962843797
Provider Name (Legal Business Name): INTERNATIONAL PSYCHOLOGICAL AND CONSULTING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 SOUTH PATRICK STREET SUITE 203
ALEXANDRIA VA
22314
US

IV. Provider business mailing address

3809-A ELBERT AVE
ALEXANDRIA VA
22305
US

V. Phone/Fax

Practice location:
  • Phone: 703-309-3185
  • Fax: 703-544-7817
Mailing address:
  • Phone: 703-309-3185
  • Fax: 703-544-7817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0810001850
License Number StateVA

VIII. Authorized Official

Name: DR. DENNIS J HUNT
Title or Position: CEO/CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 703-309-3185