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DR. EUGENE A. SHOOTER JR. PH.D. NPI 1720024821


NPI Information

NPI: 1720024821
Provider Name: DR. EUGENE A. SHOOTER, JR., PH.D.
Classification: Psychologist - 103TC0700X
Entity Type: Individual

Specialization: Clinical

PECOS Registration: Yes

Address:
5276 DAWES AVE
ALEXANDRIA, VA
ZIP 22311
Phone: (703) 379-7350
Get Directions

DR. Eugene A. Shooter, Jr., PH.D. is a clinical psychologist in Alexandria, VA with 31 years of experience. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. DR. Eugene A. Shooter, Jr., PH.D. NPI is 1720024821. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduation Year:1993

The provider's business location address is:

5276 DAWES AVE
ALEXANDRIA, VA
ZIP 22311-404
Phone: (703) 379-7350
Fax: (703) 379-7352

The NPI 1720024821 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 6/20/2006 and was last updated on 3/6/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinicalPSY1878DISTRICT OF COLUMBIANo
2103TC0700XPsychologistClinicalPSY518HAWAIINo
3103TC0700XPsychologistClinical00810002612VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1453769OTHERVIRGINIAPCI ANTHEM
22787110OTHERVIRGINIAPCI AETNA
3142975OTHERVIRGINIAANTHEM HEALTHKEEPERS
4OOB225PO9MEDICARE ID-TYPE UNSPECIFIEDVIRGINIAPCI VA MEDICARE
5007575C24MEDICARE PINDISTRICT OF COLUMBIA
648900016OTHERVIRGINIACAREFIRST BC/BS
7110936OTHERVIRGINIAPCI APS
8142975OTHERVIRGINIAT-MED BC/BS VA
9158367OTHERVIRGINIAPCI TRICARE
10158367OTHERVIRGINIAPCI VALUE OPTIONS
11G3960017OTHERDISTRICT OF COLUMBIABCBS DC
122122539OTHERVIRGINIAMAMSI
13228758OTHERVIRGINIAPCI KAISER PERMANENTE
149123953OTHERVIRGINIAPHCS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.