| Beazell Psychological Services Llc | |
|
11260 Roger Bacon Dr Ste 204 Reston VA 20190-5252 | |
| (571) 310-0201 | |
| Not Available |
| Full Name | Beazell Psychological Services Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 11260 Roger Bacon Dr Ste 204, Reston, Virginia |
| Authorized Official Name and Position | Stewart Beazell (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5713100201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beazell Psychological Services Llc 11260 Roger Bacon Dr Ste 204 Reston VA 20190-5252 Ph: (571) 310-0201 | Beazell Psychological Services Llc 11260 Roger Bacon Dr Ste 204 Reston VA 20190-5252 Ph: (571) 310-0201 |
| NPI Number | 1528700358 |
|---|---|
| Provider Enumeration Date | 04/12/2022 |
| Last Update Date | 04/12/2022 |
| Certification Date | 04/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528700358 | NPI | - | NPPES |
| 1164072146 | Other | VA | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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