Provider Demographics
NPI:1285371781
Name:VIRGINIA PSYCHOLOGICAL SOLUTIONS PLLC
Entity type:Organization
Organization Name:VIRGINIA PSYCHOLOGICAL SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:ETKIND
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, PHD
Authorized Official - Phone:703-673-7113
Mailing Address - Street 1:10332 MAIN ST # 282
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2410
Mailing Address - Country:US
Mailing Address - Phone:301-312-1003
Mailing Address - Fax:
Practice Address - Street 1:4339 ANDES DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-5360
Practice Address - Country:US
Practice Address - Phone:703-673-7113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-16
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty