Individual
DR. SHAWN GEWIRTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
500 OLD LYNCHBURG RD, CHARLOTTESVILLE, VA 22903-6500
(434) 972-1737
Mailing address
1624 SHADY GROVE CT, CHARLOTTESVILLE, VA 22902-7218
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
0810004435
VA
103TB0200X
Cognitive & Behavioral Psychologist
0810004435
VA
103TC0700X
Clinical Psychologist
0810004435
VA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
0810004435
VA
103TF0000X
Family Psychologist
0810004435
VA
103TS0200X
School Psychologist
0810004435
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942270699
—
VA
Enumeration date
07/12/2011
Last updated
07/12/2011
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