| Indian River Psychological Associates, P.c. | |
|
6477 College Park Sq Suite 302 Virginia Beach VA 23464-3611 | |
| (757) 424-0100 | |
| (757) 424-5623 |
| Full Name | Indian River Psychological Associates, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 6477 College Park Sq, Virginia Beach, Virginia |
| Authorized Official Name and Position | I. Kimberlee Chucker (PRESIDENT) |
| Authorized Official Contact | 7574240100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian River Psychological Associates, P.c. 6477 College Park Sq Suite 302 Virginia Beach VA 23464-3611 Ph: (757) 424-0100 | Indian River Psychological Associates, P.c. 6477 College Park Sq Suite 302 Virginia Beach VA 23464-3611 Ph: (757) 424-0100 |
| NPI Number | 1316016645 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9335189521 |
|---|---|
| Medicare Enrollment ID | O20050506000408 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316016645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | (* (Not Available)) | Primary |
| Provider Name | Ingrid Kimberlee Chucker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033222518 PECOS PAC ID: 3870533060 Enrollment ID: I20100920000700 |
| Provider Name | Daniel Walter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588647283 PECOS PAC ID: 2365624210 Enrollment ID: I20110314000578 |
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