Individual provider Active NPI

Tiffany Duffing, PHD

  • Clinical Psychologist
  • Burke, VA
National Provider Identifier
1033404017
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810005779 Issued in VA
Practice address
5244 Lyngate CT Ste 200
Burke, VA 22015-1631
Phone
(813) 210-7584
NPI assigned
Jun 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810005779 VA Primary

Addresses

Primary practice location

5244 Lyngate CT Ste 200
Burke, VA 22015-1631

Mailing address

PO Box 154
Fairfax Station, VA 22039-0154
Phone (703) 244-9807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 30, 2020 through Sep 30, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0810005779VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gi Psychology, PLLC Clinical Current Accepting new patients

Locations

5244 Lyngate Ct
#200
Burke, VA 22015
Phone (703) 508-4591

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1033404017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 154",
            "city": "FAIRFAX STATION",
            "state": "VA",
            "postal_code": "220390154",
            "telephone_number": "703-244-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5244 LYNGATE CT STE 200",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151631",
            "telephone_number": "813-210-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFING",
        "first_name": "TIFFANY",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burke, VA

Sources for this page

Verify at the official NPI Registry.