| Neuropsychology Associates Of Fairfax Virginia Llc | |
|
3020 Hamaker Ct Ste 103 Fairfax VA 22031-2220 | |
| (703) 876-0966 | |
| (703) 876-1628 |
| Full Name | Neuropsychology Associates Of Fairfax Virginia Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 3020 Hamaker Ct Ste 103, Fairfax, Virginia |
| Authorized Official Name and Position | Cynthia L Sullivan (OWNER) |
| Authorized Official Contact | 7038517109 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuropsychology Associates Of Fairfax Virginia Llc 3020 Hamaker Ct Ste 103 Fairfax VA 22031-2220 Ph: (703) 876-0966 | Neuropsychology Associates Of Fairfax Virginia Llc 3020 Hamaker Ct Ste 103 Fairfax VA 22031-2220 Ph: (703) 876-0966 |
| NPI Number | 1679177224 |
|---|---|
| Provider Enumeration Date | 11/24/2020 |
| Last Update Date | 11/24/2020 |
| Certification Date | 11/20/2020 |
| Medicare PECOS PAC ID | 5597171611 |
|---|---|
| Medicare Enrollment ID | O20210315001500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679177224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Mary Elizabeth Quig |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467668350 PECOS PAC ID: 5092768598 Enrollment ID: I20050224000493 |
| Provider Name | Jeffrey A Wilken |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932216280 PECOS PAC ID: 8921002650 Enrollment ID: I20060911000560 |
| Provider Name | Timothy A Fratto |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962734194 PECOS PAC ID: 8123144458 Enrollment ID: I20100923001441 |
| Provider Name | Cynthia L Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801903000 PECOS PAC ID: 4385645944 Enrollment ID: I20130405000173 |
| Provider Name | Catherine S Bergmann |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376208157 PECOS PAC ID: 8729473855 Enrollment ID: I20220328000513 |
| Provider Name | Adreanna Watts |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720726292 PECOS PAC ID: 6305222704 Enrollment ID: I20221010000695 |
| Provider Name | Kamini Krishnan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942659263 PECOS PAC ID: 6507145620 Enrollment ID: I20240212002172 |
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