Linda Domenica Fama, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810003444 Issued in VA

Practice address

313 Park Ave Ste 203
Falls Church, VA 22046-3303

Phone

(703) 891-9505

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2021 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Psychological and Life Skills Associates, P.C.

  • Psychologist
  • Woodbridge, VA
  • NPI 1619066727
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1013015999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 PARK AVE STE 203",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463303",
            "telephone_number": "703-891-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 PARK AVE STE 203",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463303",
            "telephone_number": "703-891-9505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAMA",
        "first_name": "LINDA",
        "middle_name": "DOMENICA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "352673",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Falls Church Smile Center, Inc
• Falls Church Therapy Associates
• Falls Church Wellness Center
• Abiodun Olatunde Falowo
• Mohammad Ali Falsafi
• Family and Sport Chiropractic
• Family and Sports Chiropractic ,Inc.
• Family Center Counseling
• Family Home Care Agency
• Family Home Care Provider LLC

• Clinical Psychologist in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.