Active NPI
Avy Stock
- Clinical Child & Adolescent Psychologist
- Leesburg, VA
National Provider Identifier
1003138744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 0810003939
- Practice address
- 42009 Victory LN
Leesburg, VA 20176-6269 - Phone
- (330) 758-4515
- Fax
- (330) 758-2862
- NPI assigned
- Feb 23, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 0810003939 | VA | Primary |
Addresses
Primary practice location
42009 Victory LN
Leesburg, VA 20176-6269
Mailing address
42009 Victory LN
Leesburg, VA 20176-6269
Phone (330) 758-4515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Feb 2, 2013 through Feb 2, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Ross Center for Anxiety & Related Disorders Inc | Past | Accepting new patients | |
| The Ross Center for Anxiety & Related Disorders, LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychologist
- Washington, DC
- NPI 1417127663
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Washington, DC
- NPI 1578998563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266883200000",
"number": "1003138744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42009 VICTORY LN",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201766269",
"telephone_number": "330-758-4515",
"fax_number": "330-758-2862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42009 VICTORY LN",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201766269",
"telephone_number": "330-758-4515",
"fax_number": "330-758-2862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOCK",
"first_name": "AVY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-23",
"last_updated": "2010-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "VA",
"license": "0810003939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.