Victoria Pezzullo Tate, PSYD, LCP
NPI 1427124825ActiveIndividual· Psychologist, Clinical· Charlottesville, VA
Psychologist, Clinical (PSYD, LCP) with Southeastern Physician Services PC, practicing in Charlottesville, Virginia. Medicare paid $50,309 for services to 383 patients in 2024.
Overview
| NPI | 1427124825 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD, LCP |
| Sole proprietor | Yes |
| NPI issued | Nov 28, 2006 |
| Last updated in NPPES | Mar 26, 2025 |
| Certified by provider | Mar 26, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 0810003679 | VA |
| Clinical Neuropsychologist | 103G00000X | 0810003679 | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (VA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 383 |
|---|---|
| Services billed | 466 across 5 procedure codes |
| Paid by Medicare | $50,309 |
Education and affiliations
| Graduation year | 2001 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Medical group
- Southeastern Physician Services PCSaint Peters, MO · 593 clinicians
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All 191 clinical psychologists in Charlottesville · All clinical psychologists in Virginia