DR. STEPHEN CARL GANDERSON (NPI# 1902994262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902994262 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN CARL GANDERSON |
| Credential | PSY.D. |
| Practice Address |
505 Cedar Rd Suite B-1 Chesapeake VA 23322-5585 |
| Mailing Address |
Po Box 2739 Chesapeake VA 23327-2739 |
| Practice Telephone | 7575489996 |
| Practice Fax Number | 7573825085 |
| Mailing Telephone | 7575489996 |
| Mailing Fax Number | 7573825085 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810001638 | VA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 7704755 | 05 |
| Street Address |
505 CEDAR RD SUITE B-1 |
| City | CHESAPEAKE |
| State | VA |
| Zip Code | 23322-5585 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154986347 | Center for Visual Surgical Excellence, LLC | Clinic/Center | 208 Carmichael Way, Chesapeake, VA 23322 | 2019-05-03 |
| 1235648213 | Sarah Nagy | Specialist/Technologist | 205 Rountree Drive, Chesapeake, VA 23322 | 2017-09-22 |
| 1629590286 | Jack Beverly Harris Jr. | Contractor | 156 Greengable Way, Chesapeake, VA 23322 | 2017-07-14 |
| 1528597911 | Sara Osborne | Speech-Language Pathologist | 404 Mike Trail, Chesapeake, VA 23322 | 2017-06-08 |
| 1194100198 | Kerry Maldiner | Marriage & Family Therapist | 501 Cedar Rd Ste 2c, Chesapeake, VA 23322 | 2015-07-21 |
| 1619361532 | Kathryn Restaino | Student in an Organized Health Care Education/Training Program | 705 Forest Mills Rd, Chesapeake, VA 23322 | 2015-03-28 |
| 1083037212 | Kenneth E. Grindlay | Dentist | 228 Mount Pleasant Rd., Chesapeake, VA 23322 | 2014-01-23 |
| 1841538006 | Karen Mcquarrie | Behavioral Analyst | 1200 Jamaica Avenue, Chesapeake, VA 23322 | 2013-01-23 |
| 1255615886 | Vera Roberts Jackson | Pharmacist | 321 Battlefield Blvd. South, Chesapeake, VA 23322 | 2011-09-30 |
| 1669754628 | Jacqueline Dungan | Pharmacist | 201 Hanbury Road E, Chesapeake, VA 23322 | 2011-09-15 |
| Find all providers in zip 23322 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780158931 | Elissa Lea Jarvis | Psychologist | 2010 Old Greenbrier Rd Ste J, Chesapeake, VA 23320-2619 | 2019-01-21 |
| 1598217200 | Megan Merlock Gliniecki | Psychologist | 527 Las Gaviotas Blvd, Chesapeake, VA 23322-8044 | 2016-10-28 |
| 1972988020 | Mary Faye Fields | Psychologist | 400 Tranquility Trce, Chesapeake, VA 23320-4015 | 2015-07-29 |
| 1245622638 | In Faith Psychological Services, LLC | Psychologist | 1508 Sams Cir, Pmb 138, Chesapeake, VA 23320-4589 | 2015-02-23 |
| 1245668516 | William Travis Jordan | Psychologist | 4037 Taylor Rd Ste C, Chesapeake, VA 23321-5500 | 2013-10-24 |
| 1962681288 | Gregory Lee Asgaard | Psychologist | 105 Gateway Ct, Apt. # 209, Chesapeake, VA 23320-5076 | 2007-11-02 |
| 1336366061 | William L Mulligan Phd PC | Psychologist | 1403 Greenbrier Pkwy Ste 215, Chesapeake, VA 23320-0608 | 2007-04-20 |
| 1861531824 | Erynne Hart Shatto | Psychologist | 2616 Taylor Rd Ste B, Chesapeake, VA 23321-2247 | 2007-02-06 |
| 1851352496 | James F. Lassiter | Psychologist | 2006 Old Greenbrier Road, Suite 12, Chesapeake, VA 23320-2648 | 2006-03-31 |
| 1699743203 | Michael S Weissman | Psychologist | 3210 Churchland Blvd, Suite 4, Chesapeake, VA 23321-5253 | 2006-03-09 |
| Find all providers in CHESAPEAKE | ||||
| City | CHESAPEAKE |
| Zip Code | 23322 |
Please comment or provide details below to improve the information on DR. STEPHEN CARL GANDERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.