# DOMINION PSYCHOLOGICAL ASSOCIATES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649865312
- **Authorized official:** MICHELLE JAN JOHNSON LCSW (LCSW/ADMINISTRATOR)
- **Authorized official phone:** (757) 550-5266

## Contact information

- **Practice address:** 809 MAIN STREET, STE \#101, NEWPORT NEWS, VA 23605
- **Practice address phone:** (757) 550-5266
- **Mailing address:** 1706 TODDS LN \# 331, HAMPTON, VA 23666-3123
- **Mailing address phone:** (757) 550-5266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 03/04/2021
- **Last updated:** 03/04/2021