Healthcare Provider Details

I. General information

NPI: 1144887142
Provider Name (Legal Business Name): MARIA SVERDLOVA KELLY PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA SVERDLOVA PSY.D.

II. Dates (important events)

Enumeration Date: 05/24/2019
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9211 FOREST HILL AVE STE 200
RICHMOND VA
23235-6877
US

IV. Provider business mailing address

9404 EPSON DOWNS DR
HENRICO VA
23229-6200
US

V. Phone/Fax

Practice location:
  • Phone: 804-310-3257
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810005631
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: