NPI 1073522124 · live from the CMS NPI Registry
Associated Clinical Services
Psychologist, Clinical in Springfield, VA. National Provider Identifier 1073522124, active.
NPI record
| NPI | 1073522124 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 8348 Traford Ln, Suite 102, Springfield, VA 22152 |
| Practice phone | 703-569-8731 |
| Enumerated | August 7, 2006 |
| Last updated | August 22, 2020 |
| Authorized official | Edwin Carter, President/Clinical Psychologist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical primary | 103TC0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.