Provider Demographics
NPI:1851830939
Name:COMMONWEALTH PSYCHOLOGICAL ASSOCIATES, PLC
Entity type:Organization
Organization Name:COMMONWEALTH PSYCHOLOGICAL ASSOCIATES, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:AUERBACH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-734-0787
Mailing Address - Street 1:6801 WHITTIER AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4520
Mailing Address - Country:US
Mailing Address - Phone:703-734-0787
Mailing Address - Fax:703-734-2735
Practice Address - Street 1:6801 WHITTIER AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4520
Practice Address - Country:US
Practice Address - Phone:703-734-0787
Practice Address - Fax:703-734-2735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001471103G00000X
VA0810003068103G00000X
VA0810001773103G00000X
VA0810001519103TC0700X
VA0810003853103TC0700X
VA0717000990106H00000X
VA0810000842103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty