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NEUROPSYCHOLOGICAL SERVICES OF TIDEWATER, LLC
NPI 1366956096
Clinical Neuropsychologist in Virginia Beach, VA

Active since November 16, 2017
2005 PLEASURE HOUSE RD, VIRGINIA BEACH, VA 23455(757) 301-2248(757) 689-8378 Get Directions Write a Review

NPPES record last updated: March 1, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 1, 2019, Dec 11, 2017, Nov 16, 2017 (3 updates tracked since 2017).

About Neuropsychological Services Of Tidewater, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NEUROPSYCHOLOGICAL SERVICES OF TIDEWATER, LLC (NPI 1366956096) is a healthcare organization registered as a clinical neuropsychologist in Virginia Beach, Virginia and active in the NPI registry since November 2017. The organization maintains a secondary practice location in Virginia Beach and lists Jamie Ducharme, Clinical Neuropsychologist, as its authorized official.

NPPES Registry Identity

NPI1366956096
Entity TypeOrganization
Primary Taxonomy103G00000X
Legal Business NameNEUROPSYCHOLOGICAL SERVICES OF TIDEWATER, LLC
Location Address2005 PLEASURE HOUSE RDVirginia Beach, VA 23455
Mailing Address2005 Pleasure House RdVirginia Beach, VA 23455-2709 · (757) 301-2248 · Fax (757) 689-8378
Phone(757) 301-2248
Fax(757) 689-8378
Organization SubpartNo
Authorized OfficialJamie DucharmeClinical Neuropsychologist · (757) 301-2248
Enumeration DateNovember 16, 2017
Last NPPES UpdateMarch 1, 20193 updates tracked since enumeration
✔ NPI 1366956096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in VA · 0810004265
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
2005 PLEASURE HOUSE RD, Virginia Beach, VA 23455
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Secondary Practice Location 1

Location 1575 Lynnhaven Pkwy Ste 278Virginia Beach, VA 23452-7476 · Phone (757) 301-2248

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Neuropsychological Services Of Tidewater, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Neuropsychological Services Of Tidewater, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Jamie Ducharme, PHD
Clinical Psychologist
NPI 1659533610
2005 PLEASURE HOUSE RD
Virginia Beach, VA 23455
(757) 301-2248
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Jenks, PSYD
Clinical Psychologist
NPI 1548961378
2005 PLEASURE HOUSE RD
Virginia Beach, VA 23455
(757) 301-2248
✔ PECOS✔ Accepts MedicareSame address
Brianna Bowman, LCSW
Clinical Social Worker
NPI 1205523677
829 SADDLEBACK TRAIL RD
Chesapeake, VA 23322
(616) 914-7523
✔ PECOS✔ Accepts Medicare16 mi
Kimberley Coddington, PH.D.
Clinical Psychologist
NPI 1467423756
310 CHESTNUT ST STE 230
Meadville, PA 16335
(814) 337-2037
✔ PECOS✔ Accepts Medicare391 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Neuropsychological Services Of Tidewater, LLC's NPI number?

The NPI number for Neuropsychological Services Of Tidewater, LLC is 1366956096. It was assigned to this organization in the NPPES registry on November 16, 2017.

Where is Neuropsychological Services Of Tidewater, LLC located?

Neuropsychological Services Of Tidewater, LLC is located at 2005 Pleasure House Rd, Virginia Beach, VA 23455. The listed phone number is (757) 301-2248.

What is Neuropsychological Services Of Tidewater, LLC's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Neuropsychological Services Of Tidewater, LLC enrolled in Medicare?

Yes. Neuropsychological Services Of Tidewater, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Neuropsychological Services Of Tidewater, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Neuropsychological Services Of Tidewater, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Psychologist (3) and Clinical Social Worker (1). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Neuropsychological Services Of Tidewater, LLC was last updated on March 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.