Avy Stock
Psychologist, Clinical Child & Adolescent in Leesburg, VA. Individual provider (NPI-1).
NPI number1003138744
StatusActive
Last updated in NPPESFeb 23, 2010
Details
- NPI
- 1003138744
- Entity type
- Individual (NPI-1)
- Name
- Avy Stock
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 23, 2010
- Last updated
- Feb 23, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- Medicare opt-out
- Feb 2, 2013 to Feb 2, 2027
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC2200X | Psychologist, Clinical Child & Adolescent | 0810003939 | VA | Yes |
Practice location
42009 Victory LnLeesburg, VA 20176-6269
Phone 330-758-4515 · Fax 330-758-2862
Mailing address
42009 Victory LnLeesburg, VA 20176-6269
Phone 330-758-4515 · Fax 330-758-2862
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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