Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Victoria Pezzullo Tate, PSYD, LCP

Individual provider Clinical Neuropsychologist · NPI 1427124825

Dr. Victoria Pezzullo Tate, PSYD, LCP is a Clinical Psychologist in Charlottesville, Virginia. Qualified in 2001, 25 years ago. Practices with Southeastern Physician Services PC, a 598-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
25
Licensed in
VA
In the registry since
2006
Specialties on file
2
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

420 Third St NE
Charlottesville, VA 22901
Phone: (804) 519-7191
Fax: (804) 744-2101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 0810003679 (VA)
Clinical Neuropsychologist Taxonomy 103G00000X · Licence 0810003679 (VA)

Record details

NPI number1427124825
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD , LCP
Sole proprietorYes
NPI enumeratedNovember 28, 2006
Last updated in NPPESMarch 26, 2025
Certification dateMarch 26, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Southeastern Physician Services Pc — 598 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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