Kyle Standiford, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810006379 Issued in VA

Practice address

360 Maple Ave W Ste F
Vienna, VA 22180-5614

Phone

(703) 938-0058

NPI assigned

Jun 6, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 26, 2020 through Jun 26, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dr. Goldberg & Associates

  • Clinical Psychologist
  • Vienna, VA
  • NPI 1437586526
  NPD
• Boyd Cowan, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Alexandria, VA
  • NPI 1801353719
  NPD (past)

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1033568639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MAPLE AVE W STE F",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221805614",
            "telephone_number": "703-935-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MAPLE AVE W STE F",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221805614",
            "telephone_number": "703-938-0058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6300 Stevenson Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223043554",
            "country_code": "US",
            "telephone_number": "703-935-0058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANDIFORD",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810006379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jada Squirewell
• Kanaka Sriram, D.D.S.
• Lauren Jill Staadeker, PSYD
• Hollie Blevins Stack, DDS
• Kathleen A Stahl, MD
• Roland Edward Stecher, D.D.S.
• Jason N Steele, LPC
• Katherine Ann Leonberger Stein, PSY D
• Peter Steinberg, LCSW
• Stella Brizuela-Moreno Dba International Consulting Center

• Clinical Psychologist in Vienna, VA
• Providers in Vienna, 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 20, 2020; 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.