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General NPI Number Information
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NPI Number | 1942187430
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Entity Type | Organization
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Legal Business Name | NEUROPSYCH ROANOKE LLC
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 3390 COLONIAL AVE
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City | ROANOKE
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State | VA
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Zip | 24018-3740
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Country | US
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Telephone | 757-383-5456
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Fax |
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Provider Business Mailing Address
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Address Line | 3205 NORTHSHIRE CT
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City | ROANOKE
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State | VA
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Zip | 24014-1102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELLA H PECSOK
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Credential |
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Telephone | 757-383-5456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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