Healthcare Provider Details

I. General information

NPI: 1972710937
Provider Name (Legal Business Name): ABBY CORINNE CALISCH PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 06/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 FAIRFAX AVE SUITE 710
NORFOLK VA
23507-1914
US

IV. Provider business mailing address

PO BOX 936
NORFOLK VA
23501-0936
US

V. Phone/Fax

Practice location:
  • Phone: 757-446-5888
  • Fax: 757-446-5918
Mailing address:
  • Phone: 757-446-5888
  • Fax: 757-446-5918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0551
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701004413
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: