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Contact Information

SPORT PSYENCE, LLC
5 S MONTAGUE ST
ARLINGTON, VA22204-1007
 Phone: 703-594-6585
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Exercise & Sports

103TE1100X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for SPORT PSYENCE, LLC

NPI Number 1841802816
LBN Legal business name SPORT PSYENCE, LLC
Authorized official AMBER CARGILL - (LICENSED PSYCHOLOGIST/CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/20/2020
Last updated 08/20/2020 - About 6 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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