| Loudoun Medical Group, Pc | |
|
7921 Jones Branch Drive, Suite 311 Mclean VA 22102-3334 | |
| (703) 772-4428 | |
| (571) 384-6309 |
| Full Name | Loudoun Medical Group, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 7921 Jones Branch Drive, Suite 311, Mclean, Virginia |
| Authorized Official Name and Position | Mary Beth Tamasy (CEO) |
| Authorized Official Contact | 7037376001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loudoun Medical Group, Pc 224d Cornwall St Nw Suite 403 Leesburg VA 20176-2704 Ph: (703) 737-6010 | Loudoun Medical Group, Pc 7921 Jones Branch Drive, Suite 311 Mclean VA 22102-3334 Ph: (703) 772-4428 |
| NPI Number | 1538792486 |
|---|---|
| Provider Enumeration Date | 02/19/2020 |
| Last Update Date | 04/23/2024 |
| Certification Date | 04/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538792486 | NPI | - | NPPES |
| 1675951440 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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