Provider Demographics
NPI:1114362316
Name:WINCHESTER PSYCHIATRIC CONSULTANTS, PC
Entity type:Organization
Organization Name:WINCHESTER PSYCHIATRIC CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKUMA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOGILI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-431-5067
Mailing Address - Street 1:812 AMHERST ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3344
Mailing Address - Country:US
Mailing Address - Phone:540-431-5067
Mailing Address - Fax:540-431-5067
Practice Address - Street 1:812 AMHERST ST
Practice Address - Street 2:SUITE 302
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3344
Practice Address - Country:US
Practice Address - Phone:540-431-5067
Practice Address - Fax:540-431-5067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty