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Individual

DR. RANDY A. RHOAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
640 INDEPENDENCE PKWY STE 100, CHESAPEAKE, VA 23320-5205
(757) 420-0530
(757) 420-0488
Mailing address
640 INDEPENDENCE PKWY STE 100, CHESAPEAKE, VA 23320-5205
(757) 420-0530
(757) 420-0488

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002751
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00Y131C01
MEDICARE INDIVIDUAL PTAN
VA
05
010062691
VA
01
C10841
MEDICARE GROUP PTAN
VA
Enumeration date
11/22/2006
Last updated
02/06/2025
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