Healthcare Provider Details

I. General information

NPI: 1578743027
Provider Name (Legal Business Name): NEUROPSYCHOLOGICAL ASSOCIATES OF WINCHESTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2007
Last Update Date: 11/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 W PICCADILLY STREET
WINCHESTER VA
22601
US

IV. Provider business mailing address

134 W PICCADILLY STREET
WINCHESTER VA
22601
US

V. Phone/Fax

Practice location:
  • Phone: 540-662-3400
  • Fax: 540-667-1394
Mailing address:
  • Phone: 540-662-3400
  • Fax: 540-667-1394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0810002168
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810003809
License Number StateVA

VIII. Authorized Official

Name: DR. JOHN DAVISON LEWIS
Title or Position: SOLE PARTNER
Credential: PSYD
Phone: 540-662-3400