Provider Demographics
NPI:1528159183
Name:ROCK LANDING PSYCHOLOGICAL GROUP
Entity type:Organization
Organization Name:ROCK LANDING PSYCHOLOGICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:AJA
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:757-873-1835
Mailing Address - Street 1:11825 ROCK LANDING DR
Mailing Address - Street 2:JAMES BUILDING
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4236
Mailing Address - Country:US
Mailing Address - Phone:757-587-3183
Mailing Address - Fax:757-873-1028
Practice Address - Street 1:11825 ROCK LANDING DR
Practice Address - Street 2:JAMES BUILDING
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4236
Practice Address - Country:US
Practice Address - Phone:757-587-3183
Practice Address - Fax:757-873-1028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101Y00000X101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty