| Chase Psychological Resources, Inc. | |
|
10721 Main St Suite 2350 Fairfax VA 22030-6914 | |
| (703) 591-5912 | |
| (703) 591-7210 |
| Full Name | Chase Psychological Resources, Inc. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 10721 Main St, Fairfax, Virginia |
| Authorized Official Name and Position | Lee R Chase (PSYCHOLOGIST/PRESIDENT) |
| Authorized Official Contact | 3013255043 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chase Psychological Resources, Inc. 327 Chestertown St Gaithersburg MD 20878-5686 Ph: (301) 325-5043 | Chase Psychological Resources, Inc. 10721 Main St Suite 2350 Fairfax VA 22030-6914 Ph: (703) 591-5912 |
| NPI Number | 1063696466 |
|---|---|
| Provider Enumeration Date | 12/20/2007 |
| Last Update Date | 12/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063696466 | NPI | - | NPPES |
| 1588702047 | Other | MD | NPI |
| 1861493520 | Other | MD | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 03341 (Maryland) | Secondary |
| 103TC0700X | Psychologist - Clinical | 0810002159 (Virginia) | Primary |
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