| Name | Value |
|---|---|
| PROVIDER TYPE | Behavioral Health & Social Service Providers |
| CLASSIFICATION | Psychologist |
| DEFINITION | A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. |
| AREA OF SPECIALIZATION | Prescribing (Medical) |
| STATUS | Active |
| VA CODE | V183403 |
| X12 CODE | 103TP0016X |
| SPECIALTY CODE | 62 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5252366 |
| EFFECTIVE DATE/TIME |
|