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CHASE PSYCHOLOGICAL RESOURCES, INC.

Clinical Neuropsychologist

Fairfax, Virginia

Provider NPI: 1063696466

Organization Information:
Organization Name:  CHASE PSYCHOLOGICAL RESOURCES, INC.
Organization is not Subpart
Authorized Official:  LEE R CHASE  PSYCHOLOGIST/PRESIDENT  301-3255043

Practice Location:
10721 MAIN ST SUITE 2350 FAIRFAX, VA 22030 US
Tel: 703-591-5912  Fax: 703-591-7210

Business Mailing Address:
327 CHESTERTOWN ST  GAITHERSBURG, MD 20878 US
Tel: 301-325-5043  Fax: --

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MD03341
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
VA0810002159

Other Provider Identifiers:

IssuerNumberStateType
NPI1588702047MD01
NPI1861493520MD01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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