| Jefferson And Associates Psychological Services, P.c. | |
|
3712 Old Forest Rd Suite 500 Lynchburg VA 24501-6959 | |
| (434) 385-0744 | |
| (434) 385-8358 |
| Full Name | Jefferson And Associates Psychological Services, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 3712 Old Forest Rd, Lynchburg, Virginia |
| Authorized Official Name and Position | Terry W. Jefferson (OWNER/PRESIDENT) |
| Authorized Official Contact | 4343850744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson And Associates Psychological Services, P.c. 3712 Old Forest Rd Suite 500 Lynchburg VA 24501-6959 Ph: (434) 385-0744 | Jefferson And Associates Psychological Services, P.c. 3712 Old Forest Rd Suite 500 Lynchburg VA 24501-6959 Ph: (434) 385-0744 |
| NPI Number | 1124133327 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 07/31/2015 |
| Medicare PECOS PAC ID | 1153218128 |
|---|---|
| Medicare Enrollment ID | O20040303000839 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124133327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0810001866 (Virginia) | Primary |
| 1041C0700X | Social Worker - Clinical | (Virginia) | Secondary |
| Provider Name | Susan E Eick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124119516 PECOS PAC ID: 6002931151 Enrollment ID: I20100914000457 |
| Provider Name | Terry W Jefferson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356339709 PECOS PAC ID: 3678460656 Enrollment ID: I20110510000582 |
| Provider Name | Sarah Ruth Ball |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275680696 PECOS PAC ID: 4486627635 Enrollment ID: I20111122000507 |
| Provider Name | Suzanne Rozgonyi Eaton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184709966 PECOS PAC ID: 8820246259 Enrollment ID: I20160609000207 |
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