Healthcare Provider Details

I. General information

NPI: 1679087167
Provider Name (Legal Business Name): WEST END NEUROPSYCHOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 11/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 N PARHAM RD STE 107
RICHMOND VA
23294-4409
US

IV. Provider business mailing address

9810 ST PAGES LN
RICHMOND VA
23233-1426
US

V. Phone/Fax

Practice location:
  • Phone: 804-205-7452
  • Fax: 888-757-4016
Mailing address:
  • Phone: 804-205-7452
  • Fax: 888-757-4016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number0810003758
License Number StateVA

VIII. Authorized Official

Name: DR. JENNIFER LUMPKIN
Title or Position: LICENSED CLINICAL PSYCHOLOGIST
Credential: PSY.D.
Phone: 804-205-7452