Healthcare Provider Details

I. General information

NPI: 1417039264
Provider Name (Legal Business Name): PSYCHOLOGICAL HEALTH ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S LOUDOUN ST
WINCHESTER VA
22601
US

IV. Provider business mailing address

801 S LOUDOUN ST
WINCHESTER VA
22601
US

V. Phone/Fax

Practice location:
  • Phone: 540-667-5431
  • Fax: 540-667-2655
Mailing address:
  • Phone: 540-667-5431
  • Fax: 540-667-2655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. BERNARD J LEWIS
Title or Position: OWNER
Credential: PHD
Phone: 540-667-5431