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General NPI Number Information
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NPI Number | 1053793059
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Entity Type | Organization
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Legal Business Name | ADVANCED PSYCHOTHERAPEUTICS
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 1047 VISTA PARK DR STE A
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City | FOREST
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State | VA
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Zip | 24551-4362
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Country | US
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Telephone | 434-616-2388
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Fax |
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Provider Business Mailing Address
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Address Line | 1047 VISTA PARK DR STE A
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City | FOREST
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State | VA
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Zip | 24551-4362
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Country | US
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Telephone | 434-616-2388
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. TIMOTHY H BARCLAY
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Credential | PHD
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Telephone | 434-616-2388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810004569
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License Number State | VA
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