Provider Demographics
NPI:1962843797
Name:INTERNATIONAL PSYCHOLOGICAL AND CONSULTING SERVICES, INC.
Entity type:Organization
Organization Name:INTERNATIONAL PSYCHOLOGICAL AND CONSULTING SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-309-3185
Mailing Address - Street 1:3809-A ELBERT AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22305
Mailing Address - Country:US
Mailing Address - Phone:703-309-3185
Mailing Address - Fax:703-544-7817
Practice Address - Street 1:113 SOUTH PATRICK STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314
Practice Address - Country:US
Practice Address - Phone:703-309-3185
Practice Address - Fax:703-544-7817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC0700X
VA0810001850251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA301743Medicaid