Healthcare Provider Details
I. General information
NPI: 1851992333
Provider Name (Legal Business Name): BEACH NEUROPSYCHOLOGY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/03/2020
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
317 OFFICE SQUARE LN STE B102
VIRGINIA BEACH VA
23462-3650
US
IV. Provider business mailing address
317 OFFICE SQUARE LN STE B102
VIRGINIA BEACH VA
23462-3650
US
V. Phone/Fax
- Phone: 757-703-7708
- Fax: 757-732-0953
- Phone: 757-703-7708
- Fax: 757-732-0953
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DANA
JANETTE
SARI
Title or Position: OWNER/MANAGIN MEMBER
Credential: PHD
Phone: 757-373-0614