Healthcare Provider Details

I. General information

NPI: 1164933602
Provider Name (Legal Business Name): HEALTH PSYCHOLOGY ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 03/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 KINGSTOWNE VILLAGE PKWY STE 300
ALEXANDRIA VA
22315-5883
US

IV. Provider business mailing address

5901 KINGSTOWNE VILLAGE PKWY STE 300
ALEXANDRIA VA
22315-5883
US

V. Phone/Fax

Practice location:
  • Phone: 571-384-6304
  • Fax: 571-384-6309
Mailing address:
  • Phone: 571-384-6304
  • Fax: 571-384-6309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0810004960
License Number StateVA

VIII. Authorized Official

Name: DR. NAOJI ANDREW WATSON
Title or Position: OWNER/PSYCHOLOGIST
Credential: PSY.D.
Phone: 571-384-6304