Provider Demographics
NPI:1306360425
Name:NACMED
Entity type:Organization
Organization Name:NACMED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:JUNE
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:540-999-6221
Mailing Address - Street 1:90 CHATHAM HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2566
Mailing Address - Country:US
Mailing Address - Phone:540-999-6221
Mailing Address - Fax:866-481-8299
Practice Address - Street 1:90 CHATHAM HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2566
Practice Address - Country:US
Practice Address - Phone:540-999-6221
Practice Address - Fax:866-481-8299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004462103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1952608093OtherNPI
1952608093OtherNPI