Healthcare Provider Details

I. General information

NPI: 1750142535
Provider Name (Legal Business Name): ANTHONY PETER KASS III PSY.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2024
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 PROGRESSIVE DR STE 101
CHESAPEAKE VA
23320-2849
US

IV. Provider business mailing address

1200 OLD KEMPSVILLE RD
VIRGINIA BEACH VA
23464-5900
US

V. Phone/Fax

Practice location:
  • Phone: 757-386-4578
  • Fax: 757-386-4604
Mailing address:
  • Phone: 321-482-3232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: